Healthcare Provider Details

I. General information

NPI: 1356046643
Provider Name (Legal Business Name): RICHARD HU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4279 TIERRA REJADA RD
MOORPARK CA
93021-3775
US

IV. Provider business mailing address

1040 FLYNN RD
CAMARILLO CA
93012-8705
US

V. Phone/Fax

Practice location:
  • Phone: 805-222-2323
  • Fax: 805-222-2333
Mailing address:
  • Phone: 805-673-3930
  • Fax: 805-659-3217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4351050670
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5315239730
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number205866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: