Healthcare Provider Details

I. General information

NPI: 1841132941
Provider Name (Legal Business Name): MAXWELL HU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 WESTERLY PL STE 111
NEWPORT BEACH CA
92660-2306
US

IV. Provider business mailing address

3901 WESTERLY PL STE 111
NEWPORT BEACH CA
92660-2306
US

V. Phone/Fax

Practice location:
  • Phone: 213-267-7162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039096
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: