Healthcare Provider Details

I. General information

NPI: 1316149735
Provider Name (Legal Business Name): JENNIFER SHIN-HUE HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 08/06/2024
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 S ATLANTIC BLVD STE 301
MONTEREY PARK CA
91754-6710
US

IV. Provider business mailing address

850 S. ATLANTIC BLVD. #301
MONTEREY PARK CA
91754
US

V. Phone/Fax

Practice location:
  • Phone: 626-289-8260
  • Fax: 626-289-4242
Mailing address:
  • Phone: 626-289-8260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberA107989
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA107989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: