Healthcare Provider Details

I. General information

NPI: 1336549989
Provider Name (Legal Business Name): MARIA HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3991 MACARTHUR BLVD STE 228
NEWPORT BEACH CA
92660-3009
US

IV. Provider business mailing address

3991 MACARTHUR BLVD STE 228
NEWPORT BEACH CA
92660-3009
US

V. Phone/Fax

Practice location:
  • Phone: 949-863-0988
  • Fax:
Mailing address:
  • Phone: 949-863-0988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG55957
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: