Healthcare Provider Details

I. General information

NPI: 1588746911
Provider Name (Legal Business Name): CALEN HUANG DMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YU-CHIH LIN HUANG DMS

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 SOUTH GRAND AVE
DIAMOND BAR CA
91765
US

IV. Provider business mailing address

4232 VAN BUREN ST.
CHINO CA
91710
US

V. Phone/Fax

Practice location:
  • Phone: 909-861-7350
  • Fax: 909-861-6170
Mailing address:
  • Phone: 909-861-7350
  • Fax: 909-861-6170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC8534
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: