Healthcare Provider Details

I. General information

NPI: 1902165442
Provider Name (Legal Business Name): PO-YIN HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 12/08/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 W SUNSET BLVD FL 4
LOS ANGELES CA
90027-5822
US

IV. Provider business mailing address

4950 W SUNSET BLVD FL 4
LOS ANGELES CA
90027-5822
US

V. Phone/Fax

Practice location:
  • Phone: 800-954-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA122542
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: