Healthcare Provider Details

I. General information

NPI: 1134388218
Provider Name (Legal Business Name): ERICK FRANKLIN HUANG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2008
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 CAMPUS DR STE W225
PLYMOUTH MN
55441-2752
US

IV. Provider business mailing address

3033 CAMPUS DR STE W225
PLYMOUTH MN
55441-2752
US

V. Phone/Fax

Practice location:
  • Phone: 415-429-6977
  • Fax:
Mailing address:
  • Phone: 415-429-6977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2018-02634
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOP60859085
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number081063
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR9224
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A11272
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: