Provider Demographics
NPI:1639156326
Name:HUANG, AMY HO (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:HO
Last Name:HUANG
Suffix:
Gender:F
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:PO BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-9125
Mailing Address - Fax:
Practice Address - Street 1:1101 VAN NESS AVE FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6919
Practice Address - Country:US
Practice Address - Phone:415-600-3232
Practice Address - Fax:415-447-6335
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA983122085N0700X
CA00A9831202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA800300158Medicaid
MAJ28597OtherBCBS MA
CAP00480246OtherRAILROAD MEDICARE
MA2101360Medicaid
CAP00480246OtherRAILROAD MEDICARE
I32487Medicare UPIN
MAA38574Medicare PIN
CABX000XMedicare PIN
MAJ28597OtherBCBS MA
CABX000VMedicare PIN