Healthcare Provider Details

I. General information

NPI: 1861575409
Provider Name (Legal Business Name): MIN HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WEST LOS ANGELES VA HOSPITAL - PATHOLOGY 11301 WILSHIRE BLVD
LOS ANGELES CA
90073
US

IV. Provider business mailing address

11301 WILSHIRE BLVD WEST LOS ANGELES VA MEDICAL CENTER, BLDG 500, RM 1254
LOS ANGELES CA
90073
US

V. Phone/Fax

Practice location:
  • Phone: 310-478-3711
  • Fax: 310-268-4983
Mailing address:
  • Phone: 310-478-3711
  • Fax: 310-268-4983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberA69770
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: