MEDICARE: DR. LISHUANG HUANG AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist

General Provider Information

NPI Number	:	1144619479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISHUANG HUANG AU.D.

Provider Business Mailing Address
First Line	:	1919 FRUITDALE AVE
Second Line	:	D20
City	:	SAN JOSE
State	:	CA
Zip	:	95128
Country	:	US
Telephone Number	:	702-427-5920
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 FRUITDALE AVE APT D20
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128
Country	:	US
Telephone Number	:	702-427-5920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2015
Last Update Date	:	12/07/2022

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