Provider Demographics
NPI:1285775361
Name:HSU, MELVIN S (DC)
Entity type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:S
Last Name:HSU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4173 DE MILLE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-3102
Mailing Address - Country:US
Mailing Address - Phone:408-296-1189
Mailing Address - Fax:408-296-1689
Practice Address - Street 1:1114 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3421
Practice Address - Country:US
Practice Address - Phone:408-296-1189
Practice Address - Fax:408-296-1689
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 27779111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0277790Medicare ID - Type Unspecified