Healthcare Provider Details

I. General information

NPI: 1326466426
Provider Name (Legal Business Name): ANDY HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2014
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PLAZA DRIVE
IRVINE CA
92697-2994
US

IV. Provider business mailing address

200 S MANCHESTER AVE STE 300
ORANGE CA
92868-3219
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-6699
  • Fax:
Mailing address:
  • Phone: 714-465-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA139362
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: