Provider Demographics
NPI:1982711495
Name:HUYNH, THUY NGOC (MD)
Entity type:Individual
Prefix:DR
First Name:THUY
Middle Name:NGOC
Last Name:HUYNH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1189 E CALAVERAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5502
Mailing Address - Country:US
Mailing Address - Phone:408-262-9992
Mailing Address - Fax:408-262-9591
Practice Address - Street 1:1189 E CALAVERAS BLVD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5502
Practice Address - Country:US
Practice Address - Phone:408-262-9992
Practice Address - Fax:408-262-9591
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG073028207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G730281Medicaid
CA00G730281Medicaid
CAF46664Medicare UPIN