Healthcare Provider Details

I. General information

NPI: 1356255806
Provider Name (Legal Business Name): HUALIN PANG RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AVERY PANG RD

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SKYLINE DR
MONTEREY CA
93940-4110
US

IV. Provider business mailing address

348 SOQUEL AVE
SANTA CRUZ CA
95062-2306
US

V. Phone/Fax

Practice location:
  • Phone: 831-373-3716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: