Healthcare Provider Details

I. General information

NPI: 1962566653
Provider Name (Legal Business Name): KUANG J HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 01/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 S ATLANTIC BLVD #304
MONTEREY PARK CA
91754-4730
US

IV. Provider business mailing address

850 S ATLANTIC BLVD #304
MONTEREY PARK CA
91754-4730
US

V. Phone/Fax

Practice location:
  • Phone: 626-284-6408
  • Fax: 626-284-1201
Mailing address:
  • Phone: 626-284-6408
  • Fax: 626-284-1201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA41756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: