Healthcare Provider Details

I. General information

NPI: 1053636985
Provider Name (Legal Business Name): JINWEI HU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2010
Last Update Date: 12/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2295 S VINEYARD AVE STE A SCPMG HEAD AND NECK SURGERY
ONTARIO CA
91761-7926
US

IV. Provider business mailing address

2295 S VINEYARD AVE STE A SCPMG HEAD AND NECK SURGERY
ONTARIO CA
91761-7926
US

V. Phone/Fax

Practice location:
  • Phone: 866-454-3485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA124204
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: