Healthcare Provider Details

I. General information

NPI: 1407394059
Provider Name (Legal Business Name): HSI-KUANG HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 E LA PALMA AVE
ANAHEIM CA
92806-2744
US

IV. Provider business mailing address

2011 E LA PALMA AVE
ANAHEIM CA
92806-2744
US

V. Phone/Fax

Practice location:
  • Phone: 714-991-9161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number76136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: