1013497734 NPI number — VOONG CHUANG LLC

Table of content: (NPI 1013497734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013497734 NPI number — VOONG CHUANG LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VOONG CHUANG LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DR. DAVY'S FOOT AND ANKLE PODIATRY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013497734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1030 PENNINGTON LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUPERTINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95014-4930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-786-7677
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
317 LOS GATOS SARATOGA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS GATOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95030-5310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-786-7677
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/21/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHUANG
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
SOLE MEMBER
Authorized Official Telephone Number:
408-786-7677

Provider Taxonomy Codes

  • Taxonomy code: 261QP1100X , with the licence number:  E5438 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)