Provider Demographics
NPI:1265509723
Name:HUYNH, CHAU MINH (MD)
Entity type:Individual
Prefix:DR
First Name:CHAU
Middle Name:MINH
Last Name:HUYNH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 ALUM ROCK AVE
Mailing Address - Street 2:B
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116
Mailing Address - Country:US
Mailing Address - Phone:408-272-8814
Mailing Address - Fax:408-272-8965
Practice Address - Street 1:1865 ALUM ROCK AVE
Practice Address - Street 2:B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116
Practice Address - Country:US
Practice Address - Phone:408-272-8814
Practice Address - Fax:408-272-8965
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42298207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A422980Medicaid
A29551Medicare UPIN
CA00A422980Medicaid