Healthcare Provider Details

I. General information

NPI: 1659440618
Provider Name (Legal Business Name): KENNETH KAI HUANG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KENNETH K HUANG D.C.

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5851 MISSION ST
SAN FRANCISCO CA
94112-4017
US

IV. Provider business mailing address

5851 MISSION ST
SAN FRANCISCO CA
94112-4017
US

V. Phone/Fax

Practice location:
  • Phone: 415-637-4933
  • Fax: 415-337-6638
Mailing address:
  • Phone: 415-637-4933
  • Fax: 415-337-6638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC26962
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: