Provider Demographics
NPI:1013023274
Name:HUANG, FRANK T (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:T
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FRANK
Other - Middle Name:T
Other - Last Name:HUANG
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 241011
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95241-9511
Mailing Address - Country:US
Mailing Address - Phone:209-339-7825
Mailing Address - Fax:209-339-7528
Practice Address - Street 1:1235 W VINE ST
Practice Address - Street 2:SUITE 22
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-5144
Practice Address - Country:US
Practice Address - Phone:209-334-8520
Practice Address - Fax:209-334-2109
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52167207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C521670Medicaid
CA00C521670Medicaid
00C521670Medicare PIN