Healthcare Provider Details

I. General information

NPI: 1568926913
Provider Name (Legal Business Name): YU-HAN HUANG OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2019
Last Update Date: 03/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 N GARFIELD AVE STE 403
MONTEREY PARK CA
91754-1101
US

IV. Provider business mailing address

616 N GARFIELD AVE STE 403
MONTEREY PARK CA
91754-1101
US

V. Phone/Fax

Practice location:
  • Phone: 626-566-4266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number11873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: