Healthcare Provider Details

I. General information

NPI: 1851591770
Provider Name (Legal Business Name): ELLEN HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDMUND EDELMAN'S CHILDREN COURT, DEPT 25 201 CENTRE PALZA DRIVE
MONTEREY PARK CA
91754
US

IV. Provider business mailing address

100 N. EL MOLINO ST. APT D
ALHAMBRA CA
91801
US

V. Phone/Fax

Practice location:
  • Phone: 323-526-6387
  • Fax:
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 Number16680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: