Healthcare Provider Details

I. General information

NPI: 1427575018
Provider Name (Legal Business Name): GUOFU HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 08/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N SAN MATEO DR
SAN MATEO CA
94401-2417
US

IV. Provider business mailing address

1974 PALOU AVE
SAN FRANCISCO CA
94124-2043
US

V. Phone/Fax

Practice location:
  • Phone: 415-919-8048
  • Fax:
Mailing address:
  • Phone: 415-919-8048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC17745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: