Healthcare Provider Details

I. General information

NPI: 1760448856
Provider Name (Legal Business Name): QIN HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E DUARTE RD
DUARTE CA
91010
US

IV. Provider business mailing address

PO BOX 5063
MONROVIA CA
91017-7163
US

V. Phone/Fax

Practice location:
  • Phone: 626-359-8111
  • Fax:
Mailing address:
  • Phone: 626-775-3200
  • Fax: 626-775-3271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA76271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: