Healthcare Provider Details

I. General information

NPI: 1942644307
Provider Name (Legal Business Name): GRACE HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2013
Last Update Date: 02/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 WESTWOOD PLZ SUITE 7501
LOS ANGELES CA
90095-8358
US

IV. Provider business mailing address

757 WESTWOOD PLZ SUITE 7501
LOS ANGELES CA
90095-8358
US

V. Phone/Fax

Practice location:
  • Phone: 310-267-9643
  • Fax: 310-206-3260
Mailing address:
  • Phone: 310-267-9643
  • Fax: 310-206-3260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number142809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: