Healthcare Provider Details

I. General information

NPI: 1891783437
Provider Name (Legal Business Name): RAYMOND I HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2242 CAMDEN AVE STE 201
SAN JOSE CA
95124-2029
US

IV. Provider business mailing address

2242 CAMDEN AVE STE 201
SAN JOSE CA
95124-2029
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-8784
  • Fax: 408-358-5357
Mailing address:
  • Phone: 408-356-8784
  • Fax: 408-358-5357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA70992
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA 70992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: