Provider Demographics
NPI:1033275847
Name:HUANG, DIANA (OD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 N MILPITAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-4401
Mailing Address - Country:US
Mailing Address - Phone:408-262-2020
Mailing Address - Fax:
Practice Address - Street 1:138 N MILPITAS BLVD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-4401
Practice Address - Country:US
Practice Address - Phone:408-262-2020
Practice Address - Fax:408-263-9666
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123030152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0123030Medicaid