Healthcare Provider Details

I. General information

NPI: 1770560013
Provider Name (Legal Business Name): CHARLENE HU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: XIAO LING HU MD

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5575 W LAS POSITAS BLVD STE 330
PLEASANTON CA
94588-5804
US

IV. Provider business mailing address

5575 W LAS POSITAS BLVD STE 330
PLEASANTON CA
94588-5804
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-6469
  • Fax:
Mailing address:
  • Phone: 650-723-6469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA79330
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: