Provider Demographics
NPI:1932863982
Name:HUMU HEALTH LLC
Entity Type:Organization
Organization Name:HUMU HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUKEMI
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUKU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:707-673-2515
Mailing Address - Street 1:2401 WATERMAN BLVD STE A4-275
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-1800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1261 TRAVIS BLVD STE 375
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4811
Practice Address - Country:US
Practice Address - Phone:707-673-2515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center