Provider Demographics
NPI:1386671907
Name:HSUEH, CHUNG-TSEN (MD)
Entity type:Individual
Prefix:DR
First Name:CHUNG-TSEN
Middle Name:
Last Name:HSUEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11234 ANDERSON ST
Mailing Address - Street 2:ROOM 1531
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-558-4910
Mailing Address - Fax:909-558-0219
Practice Address - Street 1:11370 ANDERSON ST
Practice Address - Street 2:SUITE 3650
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3450
Practice Address - Country:US
Practice Address - Phone:909-558-2884
Practice Address - Fax:909-558-2415
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52669207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSI03596Medicare UPIN