Provider Demographics
NPI:1144323064
Name:HSIEH, PIN-HUNG (MD)
Entity type:Individual
Prefix:DR
First Name:PIN-HUNG
Middle Name:
Last Name:HSIEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:HSIEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 15090
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92803-5090
Mailing Address - Country:US
Mailing Address - Phone:714-577-2124
Mailing Address - Fax:714-577-2125
Practice Address - Street 1:13522 NEWPORT AVE STE 102
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3707
Practice Address - Country:US
Practice Address - Phone:714-573-8200
Practice Address - Fax:714-573-9401
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA062358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A062358Medicaid
CAGN396ZMedicaid