Provider Demographics
NPI:1356443485
Name:PHUNG, HUY Q (MD)
Entity Type:Individual
Prefix:
First Name:HUY
Middle Name:Q
Last Name:PHUNG
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX AD
Mailing Address - Street 2:PROVIDER CREDENTIALING
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95992-1396
Mailing Address - Country:US
Mailing Address - Phone:530-751-3769
Mailing Address - Fax:530-751-1237
Practice Address - Street 1:4941 OLIVEHURST AVE
Practice Address - Street 2:
Practice Address - City:OLIVEHURST
Practice Address - State:CA
Practice Address - Zip Code:95961-4225
Practice Address - Country:US
Practice Address - Phone:530-743-4611
Practice Address - Fax:530-743-5770
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2014-02-26
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Provider Licenses
StateLicense IDTaxonomies
CAA83987207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH89946Medicare UPIN