Healthcare Provider Details
I. General information
NPI: 1902999188
Provider Name (Legal Business Name): MICHAEL A HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2423 FOREST AVE
SAN JOSE CA
95128-1505
US
IV. Provider business mailing address
2423 FOREST AVE
SAN JOSE CA
95128-1505
US
V. Phone/Fax
- Phone: 408-984-8488
- Fax: 408-984-2396
- Phone: 408-984-8488
- Fax: 408-984-2396
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | A37813 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: