Healthcare Provider Details

I. General information

NPI: 1972769974
Provider Name (Legal Business Name): EUGENE HUO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24451 HEALTH CENTER DR
LAGUNA HILLS CA
92653-3689
US

IV. Provider business mailing address

30 N 1900 E RM 1A071
SALT LAKE CITY UT
84132-2101
US

V. Phone/Fax

Practice location:
  • Phone: 949-837-4500
  • Fax:
Mailing address:
  • Phone: 801-339-3796
  • Fax: 801-581-2414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number7884698-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036118659
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: