Carmen Philomena Hsu, M. D.

Individual provider Active NPI Pediatrics Physician · Freedom, CA

NPI 1043365760 · NPPES record last updated Jan 31, 2017

Key facts

NPI
1043365760
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
G83166 (CA)
Practice address
222 Green Valley Rd
Freedom, CA 95019-3136
Phone
(831) 728-2969
Fax
(831) 722-9604
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G83166CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Pediatri Medical Group of Watsonville , Inc Pediatrics Past Accepting new patients
Clyne & Hsu Medical Group Inc Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GEGGCA/Endpoint/GEGGCA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G83166 CA Yes

Addresses

Primary practice location

222 Green Valley Rd
Freedom, CA 95019-3136

Mailing address

1816 16TH Ave
Santa Cruz, CA 95062-1709
Phone (831) 728-2969

Other identifiers

IdentifierTypeStateIssuer
G83166OtherCASTATE LICENSE

Other providers in Freedom, CA

All providers in Freedom, CA · Pediatrics Physician in California

Sources for this page

Verify at the official NPI Registry.