Healthcare Provider Details

I. General information

NPI: 1316961550
Provider Name (Legal Business Name): BARRY P. HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6033 W CENTURY BLVD STE 200
LOS ANGELES CA
90045-6440
US

IV. Provider business mailing address

6033 W CENTURY BLVD STE 200
LOS ANGELES CA
90045-6440
US

V. Phone/Fax

Practice location:
  • Phone: 310-215-1600
  • Fax: 310-479-1459
Mailing address:
  • Phone: 310-215-1600
  • Fax: 310-479-1459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA90561
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA90561
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207UN0903X
TaxonomyIn Vivo & In Vitro Nuclear Medicine Physician
License NumberA90561
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA90561
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: