Healthcare Provider Details

I. General information

NPI: 1467036954
Provider Name (Legal Business Name): LILI HUANG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 RHODE ISLAND ST STE 200
SAN FRANCISCO CA
94103-5188
US

IV. Provider business mailing address

PO BOX 276950
SACRAMENTO CA
95827-6950
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-5400
  • Fax: 415-369-1393
Mailing address:
  • Phone: 866-681-0738
  • Fax: 916-854-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95017199
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: