1487773693 NPI number — ENG HUAN AND TIN HLA MEDICAL CORPORATION

Table of content: (NPI 1487773693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487773693 NPI number — ENG HUAN AND TIN HLA MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENG HUAN AND TIN HLA MEDICAL CORPORATION
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:
Provider Other Organization Name Type Code:
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:
1487773693
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 JOSE FIGUERES AVE
Provider Second Line Business Mailing Address:
SUITE 430
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95116-1500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-929-6088
Provider Business Mailing Address Fax Number:
408-929-6087

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 JOSE FIGUERES AVE
Provider Second Line Business Practice Location Address:
SUITE 430
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95116-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-929-6088
Provider Business Practice Location Address Fax Number:
408-929-6087
Provider Enumeration Date:
03/28/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HLA
Authorized Official First Name:
TIN
Authorized Official Middle Name:
TIN
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
408-929-6088

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  A36658 (ENG HUAN) , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: A36657 (TIN T HLA) , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: A36657 (TIN HLA) , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , with the licence number: A36658(ENG HUAN) , 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)

  • Identifier: 00A366580 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1326098179 . This is a "INDIVI NPI FOR DR. HLA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00A366570 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1265482020 . This is a "INDIVIDUANPI FOR DR. HUAN" identifier . This identifiers is of the category "OTHER".