Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A162520 | CA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A162520 | CA |
NPI | 1215323621 |
---|---|
Provider Name | Grace Po-An Huang Amadi |
First Address | Sacramento, CA 95817-2307 |
Second Address | Sacramento, CA 95817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 25/06/2019 |