MEDICARE: CHARLENE HU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	A79330	CA

General Provider Information

NPI Number	:	1770560013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLENE HU MD

Provider Business Mailing Address
First Line	:	5575 W LAS POSITAS BLVD STE 330
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-5804
Country	:	US
Telephone Number	:	650-723-6469
Fax Number	:

Provider Business Practice Location Address
First Line	:	5575 W LAS POSITAS BLVD STE 330
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-5804
Country	:	US
Telephone Number	:	650-723-6469
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	10/05/2023

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