Healthcare Provider Details

I. General information

NPI: 1083353254
Provider Name (Legal Business Name): SCARLET HUANG PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 N RODEO DR STE 4
BEVERLY HILLS CA
90210-4514
US

IV. Provider business mailing address

421 N RODEO DR STE 4
BEVERLY HILLS CA
90210-4514
US

V. Phone/Fax

Practice location:
  • Phone: 424-377-0437
  • Fax:
Mailing address:
  • Phone: 424-377-0437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: