Healthcare Provider Details

I. General information

NPI: 1689721540
Provider Name (Legal Business Name): I HUNG HUANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PHILLIP I HUANG DDS

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15724 GALE AVE
HACIENDA HEIGHTS CA
91745-1518
US

IV. Provider business mailing address

15724 GALE AVE
HACIENDA HEIGHTS CA
91745-1518
US

V. Phone/Fax

Practice location:
  • Phone: 626-333-5244
  • Fax:
Mailing address:
  • Phone: 626-333-5244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number43974
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: