Healthcare Provider Details

I. General information

NPI: 1508141193
Provider Name (Legal Business Name): KUO-JUI HUANG LIC. A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GARY HUANG LIC. A.

II. Dates (important events)

Enumeration Date: 10/15/2011
Last Update Date: 10/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10325 S. TANTAU AVE.
CUPERTINO CA
95014
US

IV. Provider business mailing address

10325 S TANTAU AVE
CUPERTINO CA
95014-3547
US

V. Phone/Fax

Practice location:
  • Phone: 408-391-1330
  • Fax:
Mailing address:
  • Phone: 408-391-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number14400
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: