Healthcare Provider Details

I. General information

NPI: 1952467433
Provider Name (Legal Business Name): LIAN EN HUANG FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SULLIVAN AVE
DALY CITY CA
94015-2200
US

IV. Provider business mailing address

39159 PASEO PADRE PKWY 203
FREMONT CA
94538-1608
US

V. Phone/Fax

Practice location:
  • Phone: 650-991-6304
  • Fax:
Mailing address:
  • Phone: 510-505-1091
  • Fax: 510-505-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP12799
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: