Provider Demographics
NPI:1295794725
Name:HUIE, DANIEL ALLEN (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALLEN
Last Name:HUIE
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 1:1300 CRANE STREET
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:650-498-6500
Mailing Address - Fax:650-322-1329
Practice Address - Street 1:321 MIDDLEFIELD ROAD
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025
Practice Address - Country:US
Practice Address - Phone:650-498-6500
Practice Address - Fax:650-322-1329
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG075907208D00000X
CAG75907207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
F66931Medicare UPIN