Healthcare Provider Details

I. General information

NPI: 1588195176
Provider Name (Legal Business Name): ALICIA LA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALICIA HUANG

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MARSHALL ST. 3RD FLOOR #C334
REDWOOD CITY CA
94063
US

IV. Provider business mailing address

901 MARSHALL ST. 3RD FLOOR #C334
REDWOOD CITY CA
94063-2026
US

V. Phone/Fax

Practice location:
  • Phone: 650-299-2606
  • Fax:
Mailing address:
  • Phone: 626-397-5144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A16727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: