Provider Demographics
NPI:1326216250
Name:HU, SAMUEL C (RPH)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:C
Last Name:HU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 AVOCADO BLVD
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-7303
Mailing Address - Country:US
Mailing Address - Phone:619-670-2050
Mailing Address - Fax:619-670-2119
Practice Address - Street 1:3875 AVOCADO BLVD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-7303
Practice Address - Country:US
Practice Address - Phone:619-670-2050
Practice Address - Fax:619-670-2119
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 35816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist