Healthcare Provider Details

I. General information

NPI: 1104039056
Provider Name (Legal Business Name): CHI-YU ARTHUR HUANG D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CLEGHORN DR UNIT F
DIAMOND BAR CA
91765-2313
US

IV. Provider business mailing address

1100 CLEGHORN DR UNIT F
DIAMOND BAR CA
91765-2313
US

V. Phone/Fax

Practice location:
  • Phone: 213-219-1256
  • Fax:
Mailing address:
  • Phone: 213-219-1256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number57988
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: