Provider Demographics
NPI:1902047616
Name:HU, KENNETH (LAC)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:
Last Name:HU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3571 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5161
Mailing Address - Country:US
Mailing Address - Phone:408-899-6087
Mailing Address - Fax:408-982-5672
Practice Address - Street 1:3571 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5161
Practice Address - Country:US
Practice Address - Phone:408-899-6087
Practice Address - Fax:408-982-5672
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12586171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist