Healthcare Provider Details

I. General information

NPI: 1184241606
Provider Name (Legal Business Name): CHU YU HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 N HILL ST STE 200
LOS ANGELES CA
90012-2365
US

IV. Provider business mailing address

767 N HILL ST STE 200
LOS ANGELES CA
90012-2365
US

V. Phone/Fax

Practice location:
  • Phone: 213-808-1700
  • Fax:
Mailing address:
  • Phone: 213-808-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95011068
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: