Provider Demographics
NPI:1740212547
Name:HUANG, NENGCHUN (MD)
Entity Type:Individual
Prefix:DR
First Name:NENGCHUN
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NENG
Other - Middle Name:C
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4701 CHERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-2266
Mailing Address - Country:US
Mailing Address - Phone:408-376-0316
Mailing Address - Fax:408-841-7567
Practice Address - Street 1:800 POLLARD RD STE C30
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1431
Practice Address - Country:US
Practice Address - Phone:408-376-0316
Practice Address - Fax:408-841-7567
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA827112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A827110Medicare PIN
CAH81889Medicare UPIN