Healthcare Provider Details

I. General information

NPI: 1861992653
Provider Name (Legal Business Name): SHELDON X HUANG PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2018
Last Update Date: 02/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5185 BRUNSWICK DR
CYPRESS CA
90630-3611
US

IV. Provider business mailing address

5185 BRUNSWICK DR
CYPRESS CA
90630-3611
US

V. Phone/Fax

Practice location:
  • Phone: 714-209-5957
  • Fax:
Mailing address:
  • Phone: 714-209-5957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number78191
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: