Healthcare Provider Details

I. General information

NPI: 1518426352
Provider Name (Legal Business Name): SIU-YUAN LAI HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 UCLA MEDICAL PLAZA SUITE 310
LOS ANGELES CA
90095-6021
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-2144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA182424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: