Provider Demographics
NPI:1295792588
Name:HU, HOWARD (MD, MPH, SCD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:HU
Suffix:
Gender:M
Credentials:MD, MPH, SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3363 MONTEROSA DR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-1431
Mailing Address - Country:US
Mailing Address - Phone:206-886-6068
Mailing Address - Fax:
Practice Address - Street 1:3363 MONTEROSA DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-1431
Practice Address - Country:US
Practice Address - Phone:206-886-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG175714207R00000X, 2083P0500X
WA60853585207R00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6190537Medicaid
MA6190537Medicaid
MAA57152Medicare UPIN