Healthcare Provider Details

I. General information

NPI: 1740522309
Provider Name (Legal Business Name): HSIEN-LIN HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9868 BLACK GOLD RD
LA JOLLA CA
92037-1116
US

IV. Provider business mailing address

9868 BLACK GOLD RD
LA JOLLA CA
92037-1116
US

V. Phone/Fax

Practice location:
  • Phone: 858-945-0246
  • Fax:
Mailing address:
  • Phone: 858-450-1236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberAFE34622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: