Healthcare Provider Details

I. General information

NPI: 1376988964
Provider Name (Legal Business Name): LAURA JENNIFER HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4733 W SUNSET BLVD FL 3
LOS ANGELES CA
90027-6021
US

IV. Provider business mailing address

4733 W SUNSET BLVD FL 3
LOS ANGELES CA
90027-6021
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-1406
  • Fax: 866-455-3867
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: