Provider Demographics
NPI:1174546766
Name:HUA, SHERWIN E (MD)
Entity type:Individual
Prefix:
First Name:SHERWIN
Middle Name:E
Last Name:HUA
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 1:1215 PAYNE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024
Mailing Address - Country:US
Mailing Address - Phone:408-908-9753
Mailing Address - Fax:510-350-9001
Practice Address - Street 1:429 LLEWELLYN AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008
Practice Address - Country:US
Practice Address - Phone:888-588-6988
Practice Address - Fax:510-350-9001
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92574207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA92374AMedicare ID - Type UnspecifiedPPIN
CAI06483Medicare UPIN