Healthcare Provider Details

I. General information

NPI: 1982848461
Provider Name (Legal Business Name): JEAN HOU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 12/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD # SB-290
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

630 W 168TH ST VC 14-239
NEW YORK NY
10032-3725
US

V. Phone/Fax

Practice location:
  • Phone: 310-248-6240
  • Fax: 800-780-2610
Mailing address:
  • Phone: 212-305-8533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA139880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: