1073577979 NPI number — MR. HARRY H. HUANG M.D

Table of content: MR. HARRY H. HUANG M.D (NPI 1073577979)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073577979 NPI number — MR. HARRY H. HUANG M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUANG
Provider First Name:
HARRY
Provider Middle Name:
H.
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
M

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:
1073577979
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11875 DUBLIN BLVD
Provider Second Line Business Mailing Address:
STE C 140
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94568-2843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-587-2500
Provider Business Mailing Address Fax Number:
925-587-2511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3700 SUNSET LN
Provider Second Line Business Practice Location Address:
#6
Provider Business Practice Location Address City Name:
ANTIOCH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94509-6199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-755-8500
Provider Business Practice Location Address Fax Number:
925-755-8200
Provider Enumeration Date:
04/17/2006

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: 208000000X , with the licence number:  A85073 , 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: A85073 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com