Healthcare Provider Details

I. General information

NPI: 1124647482
Provider Name (Legal Business Name): ALICE ELAINE HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8631 W 3RD ST # 915E
LOS ANGELES CA
90048-5901
US

IV. Provider business mailing address

4140 W 190TH ST FL 2
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-1220
  • Fax:
Mailing address:
  • Phone: 310-423-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA190262
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number1023332
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: