Healthcare Provider Details

I. General information

NPI: 1255405155
Provider Name (Legal Business Name): HUIYING GU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N BRIDGE ST
VISALIA CA
93291-5014
US

IV. Provider business mailing address

305 E CENTER AVE 192 SOUTH COURT ST.
VISALIA CA
93291-6331
US

V. Phone/Fax

Practice location:
  • Phone: 559-734-1939
  • Fax: 559-624-0841
Mailing address:
  • Phone: 559-625-0888
  • Fax: 559-625-0688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA89633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: