Healthcare Provider Details

I. General information

NPI: 1679659155
Provider Name (Legal Business Name): MINGXUN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 E 120TH ST
LOS ANGELES CA
90059-3052
US

IV. Provider business mailing address

18424 BETTY WAY
CERRITOS CA
90703-6318
US

V. Phone/Fax

Practice location:
  • Phone: 310-668-2013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS22110
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: