Healthcare Provider Details

I. General information

NPI: 1609819358
Provider Name (Legal Business Name): ALBERT HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 11/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24451 HEALTH CENTER DR
LAGUNA HILLS CA
92653-3689
US

IV. Provider business mailing address

PO BOX 6388
SAN PEDRO CA
90734-6388
US

V. Phone/Fax

Practice location:
  • Phone: 949-452-3053
  • Fax: 949-452-3066
Mailing address:
  • Phone: 310-225-3244
  • Fax: 310-698-7054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA68732
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: