Healthcare Provider Details

I. General information

NPI: 1700136660
Provider Name (Legal Business Name): ZHAOJUN HUANG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 FLORENCE AVE
BELL GARDENS CA
90201-8900
US

IV. Provider business mailing address

203 N RAYMOND AVE APT C
ALHAMBRA CA
91801-6608
US

V. Phone/Fax

Practice location:
  • Phone: 562-928-9700
  • Fax:
Mailing address:
  • Phone: 310-254-6318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP20797
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: