Provider Demographics
NPI:1225371800
Name:HUANG, ANDY (LAC, DAOM, OM)
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:LAC, DAOM, OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10502 PERALTA CT
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-6568
Mailing Address - Country:US
Mailing Address - Phone:650-210-8686
Mailing Address - Fax:
Practice Address - Street 1:10502 PERALTA CT
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-6568
Practice Address - Country:US
Practice Address - Phone:408-489-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
154560171100000X
CA15164171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty