Basic Information
Provider Information
NPI: 1902267438
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HSIEH
FirstName: MINDY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1182 N EUCLID ST
Address2:  
City: ANAHEIM
State: CA
PostalCode: 928011900
CountryCode: US
TelephoneNumber: 7143999222
FaxNumber: 7143999226
Practice Location
Address1: 1182 N EUCLID ST
Address2:  
City: ANAHEIM
State: CA
PostalCode: 928011900
CountryCode: US
TelephoneNumber: 7143999222
FaxNumber: 7143999226
Other Information
ProviderEnumerationDate: 03/10/2016
LastUpdateDate: 12/13/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X559817CAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


Home