Healthcare Provider Details

I. General information

NPI: 1740212547
Provider Name (Legal Business Name): NENGCHUN HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NENG C HUANG M.D.

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 POLLARD RD STE C30
LOS GATOS CA
95032-1431
US

IV. Provider business mailing address

4701 CHERRYWOOD DR
SAN JOSE CA
95129-2266
US

V. Phone/Fax

Practice location:
  • Phone: 408-376-0316
  • Fax: 408-841-7567
Mailing address:
  • Phone: 408-376-0316
  • Fax: 408-841-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA82711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: