Healthcare Provider Details

I. General information

NPI: 1043605116
Provider Name (Legal Business Name): LAURA C. HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2015
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2452 WATSON CT
PALO ALTO CA
94303-3216
US

IV. Provider business mailing address

325 9TH AVE # 359608
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-6995
  • Fax:
Mailing address:
  • Phone: 206-685-4749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD.MD.60936514
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: