Healthcare Provider Details

I. General information

NPI: 1760160279
Provider Name (Legal Business Name): CALVIN WEI-MING HUANG PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3851 KATELLA AVE STE 255
LOS ALAMITOS CA
90720-3353
US

IV. Provider business mailing address

4281 KATELLA AVE STE 120
LOS ALAMITOS CA
90720-3592
US

V. Phone/Fax

Practice location:
  • Phone: 562-732-4578
  • Fax:
Mailing address:
  • Phone: 562-732-4578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: