Healthcare Provider Details

I. General information

NPI: 1447990122
Provider Name (Legal Business Name): KEVIN HUA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 VAN NESS AVE
SAN FRANCISCO CA
94109-6978
US

IV. Provider business mailing address

PO BOX 276950
SACRAMENTO CA
95827-6950
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-5760
  • Fax:
Mailing address:
  • Phone: 866-681-0738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20A24418
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: