Provider Demographics
NPI:1235107053
Name:HU, SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:HU
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 Q ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7058
Practice Address - Country:US
Practice Address - Phone:916-733-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061655207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A968160OtherBLLUE SHIELD
CA243676OtherUNITED HEALTHCARE
CA5963518OtherCIGNA
CAMCMG487700OtherWESTERN HEALTH ADVANTAGE
CA7735552OtherAETNA
CA132693OtherHEALTH NET
CA2091818OtherGREAT WEST
CA454758OtherINTERPLAN
CA5716517OtherFIRST HEALTH
CAA96816OtherBLUE CROSS
CA000810815028OtherPHCS
CA00968160Medicaid
CA90205904OtherPACIFICARE
CA132693OtherHEALTH NET
CA5963518OtherCIGNA