Basic Information
Provider Information
NPI: 1750769998
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUANG
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 39400 PASEO PADRE PKWY
Address2:  
City: FREMONT
State: CA
PostalCode: 945382310
CountryCode: US
TelephoneNumber: 5104585459
FaxNumber:  
Practice Location
Address1: 1319 PUNAHOU ST STE 824
Address2:  
City: HONOLULU
State: HI
PostalCode: 968261032
CountryCode: US
TelephoneNumber: 8082036518
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/07/2015
LastUpdateDate: 12/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207V00000XA162074CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home