Healthcare Provider Details

I. General information

NPI: 1073577979
Provider Name (Legal Business Name): HARRY H. HUANG M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 SUNSET LN #6
ANTIOCH CA
94509-6199
US

IV. Provider business mailing address

11875 DUBLIN BLVD STE C 140
DUBLIN CA
94568-2843
US

V. Phone/Fax

Practice location:
  • Phone: 925-755-8500
  • Fax: 925-755-8200
Mailing address:
  • Phone: 925-587-2500
  • Fax: 925-587-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA85073
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: