Healthcare Provider Details

I. General information

NPI: 1538244611
Provider Name (Legal Business Name): WENHSIUNG LUKE HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: W LUKE HUANG M.D.

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 W CENTRAL AVE SUITE 119
BREA CA
92821-3006
US

IV. Provider business mailing address

340 W CENTRAL AVE SUITE 119
BREA CA
92821-3006
US

V. Phone/Fax

Practice location:
  • Phone: 714-990-0375
  • Fax: 714-990-0305
Mailing address:
  • Phone: 714-990-0375
  • Fax: 714-990-0305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA29899
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: