Provider Demographics
NPI:1275682650
Name:HUANG, EDWARD SHENGWEN (MD, MPH)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:SHENGWEN
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E EL CAMINO REAL
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2833
Mailing Address - Country:US
Mailing Address - Phone:650-934-7575
Mailing Address - Fax:650-934-7574
Practice Address - Street 1:701 E EL CAMINO REAL
Practice Address - Street 2:1ST FLOOR
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2833
Practice Address - Country:US
Practice Address - Phone:650-934-7575
Practice Address - Fax:650-934-7574
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94260207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFY774AMedicare PIN