Healthcare Provider Details

I. General information

NPI: 1407909468
Provider Name (Legal Business Name): HUANG OPHTHALMOLOGY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 W. DUARTE RD., SUITE 100-D
ARCADIA CA
91007-7113
US

IV. Provider business mailing address

650 W. DUARTE RD., SUITE 100-D
ARCADIA CA
91007-7113
US

V. Phone/Fax

Practice location:
  • Phone: 626-446-6682
  • Fax:
Mailing address:
  • Phone: 626-446-6682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG83095
License Number StateCA

VIII. Authorized Official

Name: MORGAN HUANG
Title or Position: CEO
Credential: MD
Phone: 626-446-6682