Healthcare Provider Details

I. General information

NPI: 1982131892
Provider Name (Legal Business Name): ALEX ZHICONG HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 MOUNT VERNON AVE
BAKERSFIELD CA
93306-4018
US

IV. Provider business mailing address

5920 SEACREST VIEW RD
SAN DIEGO CA
92121-4351
US

V. Phone/Fax

Practice location:
  • Phone: 661-326-2117
  • Fax:
Mailing address:
  • Phone: 858-366-8729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA157902
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: