Healthcare Provider Details

I. General information

NPI: 1902616154
Provider Name (Legal Business Name): CALVIN HUYNH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 SUPERIOR AVE STE A
NEWPORT BEACH CA
92663-2700
US

IV. Provider business mailing address

212 BISHOP LNDG
IRVINE CA
92620-7328
US

V. Phone/Fax

Practice location:
  • Phone: 949-393-2240
  • Fax:
Mailing address:
  • Phone: 714-261-7453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: