Healthcare Provider Details

I. General information

NPI: 1013659945
Provider Name (Legal Business Name): SARA LIEN HUYNH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 JAMES WAY STE 106
PISMO BEACH CA
93449-4974
US

IV. Provider business mailing address

2 JAMES WAY STE 106
PISMO BEACH CA
93449-4974
US

V. Phone/Fax

Practice location:
  • Phone: 805-473-7665
  • Fax: 805-473-7666
Mailing address:
  • Phone: 805-473-7665
  • Fax: 805-473-7666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A21771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: