Provider Demographics
NPI:1932311321
Name:CHARLENE HU NEUROLOLGY CLINIC, INC.
Entity Type:Organization
Organization Name:CHARLENE HU NEUROLOLGY CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-600-8220
Mailing Address - Street 1:4466 BLACK AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6130
Mailing Address - Country:US
Mailing Address - Phone:925-600-8220
Mailing Address - Fax:925-600-8221
Practice Address - Street 1:4466 BLACK AVE STE A
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6130
Practice Address - Country:US
Practice Address - Phone:925-600-8220
Practice Address - Fax:925-600-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA793302084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ30907ZMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER