Provider Demographics
NPI:1508086273
Name:FU, HONG J
Entity Type:Individual
Prefix:
First Name:HONG
Middle Name:J
Last Name:FU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 SARATOGA AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3418
Mailing Address - Country:US
Mailing Address - Phone:408-557-8268
Mailing Address - Fax:
Practice Address - Street 1:1080 SARATOGA AVE STE 4
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3418
Practice Address - Country:US
Practice Address - Phone:408-557-8268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8690174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist