Individual
STEPHANIE SU HUANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
34 MARK WEST SPRINGS RD, SANTA ROSA, CA 95403-1766
(707) 541-3690
(707) 573-5433
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(707) 541-3590
(707) 573-5433
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A91911
CA
207YS0123X
Facial Plastic Surgery Physician
A91911
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A919110
BLUE SHIELD OF CALIFORNIA
CA
05
—
1699963231
—
CA
01
—
P00933203
RAILROAD MEDICARE
CA
Enumeration date
10/09/2007
Last updated
06/08/2021
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