Healthcare Provider Details

I. General information

NPI: 1831376094
Provider Name (Legal Business Name): ALBERT HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 08/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12442 LIMONITE AVE UNIT 211
EASTVALE CA
91752-2467
US

IV. Provider business mailing address

8780 19TH STREET # 278
ALTA LOMA CA
91701
US

V. Phone/Fax

Practice location:
  • Phone: 909-236-7388
  • Fax:
Mailing address:
  • Phone: 909-236-7388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMT190761
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD441833
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: