Provider Demographics
NPI:1922710078
Name:HUYNH, ERIC (DPT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HUYNH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 14TH AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4048
Mailing Address - Country:US
Mailing Address - Phone:408-637-9114
Mailing Address - Fax:
Practice Address - Street 1:6 QUAIL RUN CIR UNIT 104
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-2345
Practice Address - Country:US
Practice Address - Phone:800-476-0043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist