Provider Demographics
NPI:1255888574
Name:HUANG, KERRY (DC)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39355 CALIFORNIA ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39355 CALIFORNIA ST
Practice Address - Street 2:SUITE 106
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1447
Practice Address - Country:US
Practice Address - Phone:510-796-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor