Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | A99960 | CA |
N | 208000000X | Pediatrician | A99960 | CA |
NPI | 1700045150 |
---|---|
Provider Name | Dr. Edward Kung Hu |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 08/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1902846306 | GROUP NPI (01) | CA |
GR0100430 | GROUP MEDICAL (01) | CA |
W18762 | GROUP MEDICARE (01) | CA |