Healthcare Provider Details

I. General information

NPI: 1548340607
Provider Name (Legal Business Name): KE-QIN HU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCI MEDICAL CENTER 101 THE CITY DRIVE SOUTH
ORANGE CA
92868
US

IV. Provider business mailing address

UCI DEPARTMENT OF MEDICINE PO BOX 54509
LOS ANGELES CA
90054-4509
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-8978
  • Fax:
Mailing address:
  • Phone: 714-456-6369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number000000A62017
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberA62017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: