Provider Demographics
NPI:1043281934
Name:HSU, VANESSA D (OD)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:D
Last Name:HSU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3612 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-3847
Mailing Address - Country:US
Mailing Address - Phone:714-769-2020
Mailing Address - Fax:714-769-2021
Practice Address - Street 1:3612 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-3847
Practice Address - Country:US
Practice Address - Phone:714-769-2020
Practice Address - Fax:714-769-2021
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11895TPL152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550902230OtherVSP
CAV07638Medicare UPIN
CZ863AMedicare PIN