Healthcare Provider Details

I. General information

NPI: 1518983493
Provider Name (Legal Business Name): JENNIFER I HUI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/06/2020
Certification Date: 07/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41990 COOK ST BUILDING F #1007
PALM DESERT CA
92211-6100
US

IV. Provider business mailing address

41990 COOK ST BLDG F
PALM DESERT CA
92211-6100
US

V. Phone/Fax

Practice location:
  • Phone: 760-610-2677
  • Fax: 760-610-6101
Mailing address:
  • Phone: 760-610-2677
  • Fax: 760-610-6101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA115818
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME95255
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License NumberA115818
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: