Healthcare Provider Details

I. General information

NPI: 1457310641
Provider Name (Legal Business Name): BENJAMIN E HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 N ROSE DR
PLACENTIA CA
92870-3802
US

IV. Provider business mailing address

PO BOX 4259
CERRITOS CA
90703-4259
US

V. Phone/Fax

Practice location:
  • Phone: 562-407-2080
  • Fax:
Mailing address:
  • Phone: 562-407-2070
  • Fax: 562-407-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG85607
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: