Healthcare Provider Details

I. General information

NPI: 1669055752
Provider Name (Legal Business Name): CHIA GEORGE HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14221 EUCLID ST STE F
GARDEN GROVE CA
92843-4991
US

IV. Provider business mailing address

68 SALTON
IRVINE CA
92602-2425
US

V. Phone/Fax

Practice location:
  • Phone: 714-891-2739
  • Fax:
Mailing address:
  • Phone: 626-641-7517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25542
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: