Healthcare Provider Details
I. General information
NPI: 1760270227
Provider Name (Legal Business Name): HEALTHHUB LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 FLOCCHINI CIR STE 400
LINCOLN CA
95648-1777
US
IV. Provider business mailing address
110 FLOCCHINI CIR STE 400
LINCOLN CA
95648-1777
US
V. Phone/Fax
- Phone: 916-880-8480
- Fax:
- Phone: 916-880-8480
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANNY
KWON
Title or Position: CEO
Credential: JD
Phone: 916-880-8480