Healthcare Provider Details

I. General information

NPI: 1053322743
Provider Name (Legal Business Name): HELEN C HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 S AZUSA AVE STE 209
HACIENDA HEIGHTS CA
91745-6854
US

IV. Provider business mailing address

1850 S AZUSA AVE STE 209
HACIENDA HEIGHTS CA
91745-6854
US

V. Phone/Fax

Practice location:
  • Phone: 626-810-8688
  • Fax: 626-810-8978
Mailing address:
  • Phone: 626-810-8688
  • Fax: 626-810-8978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG69976
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: