Healthcare Provider Details

I. General information

NPI: 1710173539
Provider Name (Legal Business Name): ELAINE PEI LAN HUANG FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2007
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7740 RANCHO SANTE FE ROAD
CARLSBAD CA
92009-8685
US

IV. Provider business mailing address

1037 SUNSET CROSSING PT
SAN DIEGO CA
92154-5832
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax: 401-652-9787
Mailing address:
  • Phone: 562-715-8186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP 17140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: