Healthcare Provider Details

I. General information

NPI: 1063632487
Provider Name (Legal Business Name): ALLEN HUANG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15586 GALE AVE
HACIENDA HEIGHTS CA
91745-1513
US

IV. Provider business mailing address

15586 E.GALE AVENUE
HACIENDA HEIGHT CA
91745
US

V. Phone/Fax

Practice location:
  • Phone: 626-855-0858
  • Fax:
Mailing address:
  • Phone: 626-465-1029
  • Fax: 626-600-5448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC25709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: