Healthcare Provider Details

I. General information

NPI: 1285861542
Provider Name (Legal Business Name): VICTORIA HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6345 BALBOA BLVD STE 365
ENCINO CA
91316-1511
US

IV. Provider business mailing address

6345 BALBOA BLVD STE 365
ENCINO CA
91316-1511
US

V. Phone/Fax

Practice location:
  • Phone: 818-643-5082
  • Fax: 818-643-7098
Mailing address:
  • Phone: 818-643-5082
  • Fax: 818-643-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA114230
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: