Provider Demographics
NPI:1427789122
Name:MA, HUY (PHARMD)
Entity type:Individual
Prefix:
First Name:HUY
Middle Name:
Last Name:MA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1852 QUIMBY RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-1241
Mailing Address - Country:US
Mailing Address - Phone:408-705-7069
Mailing Address - Fax:
Practice Address - Street 1:43 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4010
Practice Address - Country:US
Practice Address - Phone:650-579-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH81039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RPH81039OtherCALIFORNIA BOARD OF PHARMACY