Healthcare Provider Details

I. General information

NPI: 1124348537
Provider Name (Legal Business Name): HUI LAN HUANG RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 FOOTHILL BLVD
LA VERNE CA
91750-3450
US

IV. Provider business mailing address

9642 EMPEROR AVE
ARCADIA CA
91007-7811
US

V. Phone/Fax

Practice location:
  • Phone: 909-593-2619
  • Fax: 909-593-6789
Mailing address:
  • Phone: 626-574-2140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: