Healthcare Provider Details

I. General information

NPI: 1346866555
Provider Name (Legal Business Name): TIAN YING HUANG DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 11/03/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 FREMONT AVE
LOS ALTOS CA
94024-4812
US

IV. Provider business mailing address

644 FREMONT AVE
LOS ALTOS CA
94024-4812
US

V. Phone/Fax

Practice location:
  • Phone: 650-948-8900
  • Fax:
Mailing address:
  • Phone: 650-750-5463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number34806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: