Healthcare Provider Details

I. General information

NPI: 1386275212
Provider Name (Legal Business Name): ANTONY P HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9521 DALEN ST
DOWNEY CA
90242-4847
US

IV. Provider business mailing address

9521 DALEN ST
DOWNEY CA
90242-4847
US

V. Phone/Fax

Practice location:
  • Phone: 866-413-1578
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49897
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: