Provider Demographics
NPI:1043699382
Name:HU, STACY NINA (OD, MS)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:NINA
Last Name:HU
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:795 E. SECOND ST.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-2007
Mailing Address - Country:US
Mailing Address - Phone:909-706-3899
Mailing Address - Fax:909-706-3773
Practice Address - Street 1:795 E. SECOND ST.
Practice Address - Street 2:SUITE 2
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766
Practice Address - Country:US
Practice Address - Phone:909-706-3899
Practice Address - Fax:909-706-3773
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA33494152W00000X
WA60559136152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist