Provider Demographics
NPI:1215323621
Name:AMADI, GRACE PO-AN HUANG (MD)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:PO-AN HUANG
Last Name:AMADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4860 Y ST STE 1600
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-3630
Mailing Address - Fax:916-734-5636
Practice Address - Street 1:4860 Y ST STE 1600
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-734-3630
Practice Address - Fax:916-734-5636
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA162520207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine