Healthcare Provider Details

I. General information

NPI: 1447312483
Provider Name (Legal Business Name): J. ANDREW HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: J. ANDREW HUANG M.D.

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 W 7TH ST
OXNARD CA
93030-6755
US

IV. Provider business mailing address

911 W 7TH ST
OXNARD CA
93030-6755
US

V. Phone/Fax

Practice location:
  • Phone: 805-487-9492
  • Fax: 805-487-2596
Mailing address:
  • Phone: 805-487-9492
  • Fax: 805-487-2596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number000A31140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: