Provider Demographics
NPI:1568655462
Name:HUANG, WILLIS (MD PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIS
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD PHD
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Mailing Address - Street 1:2281 PARAGON DR
Mailing Address - Street 2:ROBIN MONTGOMERY, CREDENTIALING MANAGER NCI/VRI
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-1307
Mailing Address - Country:US
Mailing Address - Phone:408-961-2649
Mailing Address - Fax:408-244-6596
Practice Address - Street 1:2281 PARAGON DR
Practice Address - Street 2:ROBIN MONTGOMERY, CREDENTIALING MANAGER NCI/VRI
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-1307
Practice Address - Country:US
Practice Address - Phone:408-961-2649
Practice Address - Fax:408-244-6596
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2015-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA980532085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology