Healthcare Provider Details

I. General information

NPI: 1659344802
Provider Name (Legal Business Name): ANTHONY JOSEPH HUANG O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 03/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14329 WOODRUFF AVE SUITE E
BELLFLOWER CA
90706-3260
US

IV. Provider business mailing address

17100 NORWALK BLVD STE 107
CERRITOS CA
90703-2750
US

V. Phone/Fax

Practice location:
  • Phone: 562-867-8302
  • Fax: 562-867-7046
Mailing address:
  • Phone: 562-867-8302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10496T
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3217
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: