Provider Demographics
NPI:1700361011
Name:HUA, PIERCE
Entity Type:Individual
Prefix:
First Name:PIERCE
Middle Name:
Last Name:HUA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 E ROSEVILLE PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3081
Mailing Address - Country:US
Mailing Address - Phone:916-740-1600
Mailing Address - Fax:916-740-1601
Practice Address - Street 1:1420 E ROSEVILLE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3081
Practice Address - Country:US
Practice Address - Phone:916-740-1600
Practice Address - Fax:916-740-1601
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH235825183500000X
CA77921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist