Provider Demographics
NPI:1912446279
Name:MICHAEL J HUANG MD INC
Entity Type:Organization
Organization Name:MICHAEL J HUANG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-472-6454
Mailing Address - Street 1:1301 SECRET RAVINE PKWY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3102
Mailing Address - Country:US
Mailing Address - Phone:916-472-6454
Mailing Address - Fax:916-755-4981
Practice Address - Street 1:1301 SECRET RAVINE PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3102
Practice Address - Country:US
Practice Address - Phone:916-472-6454
Practice Address - Fax:916-755-4981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty