Healthcare Provider Details

I. General information

NPI: 1881828960
Provider Name (Legal Business Name): BRENDA HUANG R.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2009
Last Update Date: 05/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EL CAMINOREAL
SOUTH SAN FRANCISCO CA
94080
US

IV. Provider business mailing address

678 ORCHID DR
SOUTH SAN FRANCISCO CA
94080-2258
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-2770
  • Fax:
Mailing address:
  • Phone: 650-225-9767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 17957
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: