Provider Demographics
NPI:1013043934
Name:HUEY, GARY (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:HUEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BAYWOOD AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1537
Mailing Address - Country:US
Mailing Address - Phone:650-373-7808
Mailing Address - Fax:650-373-7809
Practice Address - Street 1:1 BAYWOOD AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1537
Practice Address - Country:US
Practice Address - Phone:650-373-7808
Practice Address - Fax:650-373-7809
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72106207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G721060Medicare ID - Type Unspecified
F37901Medicare UPIN