Healthcare Provider Details

I. General information

NPI: 1194642397
Provider Name (Legal Business Name): KEVIN HU RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 MEDICAL CENTER CT
CHULA VISTA CA
91911-6617
US

IV. Provider business mailing address

2014 LUZON LN UNIT 6
CHULA VISTA CA
91915-1437
US

V. Phone/Fax

Practice location:
  • Phone: 619-384-9128
  • Fax:
Mailing address:
  • Phone: 619-384-9128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number83647
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: