Provider Demographics
NPI:1780038687
Name:HU, HELEN (OMD LAC)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:HU
Suffix:
Gender:F
Credentials:OMD LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 LAURETTA ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-2418
Mailing Address - Country:US
Mailing Address - Phone:619-987-6506
Mailing Address - Fax:
Practice Address - Street 1:5410 LAURETTA ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2418
Practice Address - Country:US
Practice Address - Phone:619-987-6506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-17
Last Update Date:2016-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9141171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC 9141OtherCALIFORNIA ACUPUNCT LICENSE