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General NPI Number Information
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NPI Number | 1184387052
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Entity Type | Organization
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Legal Business Name | HUMU HEALTH LLC
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 11/27/2021
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Provider Practice Location Address
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Address Line | 1261 TRAVIS BLVD STE 375
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City | FAIRFIELD
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State | CA
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Zip | 94533-4811
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Country | US
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Telephone | 707-763-2515
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 WATERMAN BLVD STE A4-275
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City | FAIRFIELD
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State | CA
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Zip | 94534-1800
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Country | US
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Telephone | 714-323-3822
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DR. OLUKEMI A KUKU
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Credential | DNP
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Telephone | 707-763-2515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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