Healthcare Provider Details

I. General information

NPI: 1164034609
Provider Name (Legal Business Name): MS. JULIE LUC HUYNH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 S FLOWER ST STE 100
LOS ANGELES CA
90015-2123
US

IV. Provider business mailing address

1521 APPIAN WAY
MONTEBELLO CA
90640-1819
US

V. Phone/Fax

Practice location:
  • Phone: 213-766-7999
  • Fax:
Mailing address:
  • Phone: 626-213-9819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number90135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: