Healthcare Provider Details

I. General information

NPI: 1306919691
Provider Name (Legal Business Name): DAVID CHUN KANG HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 VICTORIA ST SUITE# 2B
COSTA MESA CA
92627-1906
US

IV. Provider business mailing address

275 VICTORIA ST SUITE# 2B
COSTA MESA CA
92627-1906
US

V. Phone/Fax

Practice location:
  • Phone: 949-722-6178
  • Fax: 949-722-6908
Mailing address:
  • Phone: 949-722-6178
  • Fax: 949-722-6908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA44680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: