Provider Demographics
NPI:1487773693
Name:ENG HUAN AND TIN HLA MEDICAL CORPORATION
Entity type:Organization
Organization Name:ENG HUAN AND TIN HLA MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIN
Authorized Official - Middle Name:TIN
Authorized Official - Last Name:HLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-929-6088
Mailing Address - Street 1:200 JOSE FIGUERES AVE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1500
Mailing Address - Country:US
Mailing Address - Phone:408-929-6088
Mailing Address - Fax:408-929-6087
Practice Address - Street 1:200 JOSE FIGUERES AVE
Practice Address - Street 2:SUITE 430
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1500
Practice Address - Country:US
Practice Address - Phone:408-929-6088
Practice Address - Fax:408-929-6087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36658 (ENG HUAN)207R00000X
CAA36657 (TIN T HLA)207R00000X
CAA36657 (TIN HLA)207RH0003X
CAA36658(ENG HUAN)207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A366580Medicaid
1326098179OtherINDIVI NPI FOR DR. HLA
CA00A366570Medicaid
1265482020OtherINDIVIDUANPI FOR DR. HUAN
CA00A366570Medicaid
1265482020OtherINDIVIDUANPI FOR DR. HUAN
AH1622489OtherDEA NO FOR DR. HLA
CA00A366580Medicare ID - Type UnspecifiedENG HUAN, M.D.'S
1326098179OtherINDIVI NPI FOR DR. HLA
AH1622477OtherDEA NO FOR DR. HUAN