Healthcare Provider Details

I. General information

NPI: 1992923833
Provider Name (Legal Business Name): GRACE WOAN-CHING HUANG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 N FRESNO ST
FRESNO CA
93720-2941
US

IV. Provider business mailing address

7300 N FRESNO ST
FRESNO CA
93720-2942
US

V. Phone/Fax

Practice location:
  • Phone: 559-448-4154
  • Fax:
Mailing address:
  • Phone: 559-448-4154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A9345
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number20A9345
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number20A9345
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: