Healthcare Provider Details

I. General information

NPI: 1447292685
Provider Name (Legal Business Name): ROSALIE C HUYNH AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 11/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 W LA VETA AVE STE 201
ORANGE CA
92866-2607
US

IV. Provider business mailing address

1116 E CARLETON AVE
ORANGE CA
92867-3868
US

V. Phone/Fax

Practice location:
  • Phone: 714-927-7888
  • Fax:
Mailing address:
  • Phone: 714-927-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1805
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA3726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: