1043359904 NPI number — DR. MINDY MIN ZHONG HUANG GAO DDS

Table of content: DR. MINDY MIN ZHONG HUANG GAO DDS (NPI 1043359904)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043359904 NPI number — DR. MINDY MIN ZHONG HUANG GAO DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUANG GAO
Provider First Name:
MINDY
Provider Middle Name:
MIN ZHONG
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUANG
Provider Other First Name:
MIN ZHONG
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043359904
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
119 MONROE DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALO ALTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94306
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-722-3071
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
530 SHOWERS DRIVE
Provider Second Line Business Practice Location Address:
SUITE #3
Provider Business Practice Location Address City Name:
MOUNTAIN VIEW
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-917-8348
Provider Business Practice Location Address Fax Number:
650-917-8349
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  43018 , 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)





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