Provider Demographics
NPI:1700544608
Name:HUANG, YUANLONG
Entity Type:Individual
Prefix:
First Name:YUANLONG
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 O'CONNOR DR STE 27
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1655
Mailing Address - Country:US
Mailing Address - Phone:408-641-9133
Mailing Address - Fax:408-998-7215
Practice Address - Street 1:100 O'CONNOR DR STE 27
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1655
Practice Address - Country:US
Practice Address - Phone:408-641-9133
Practice Address - Fax:408-998-7215
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19321171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist