Healthcare Provider Details

I. General information

NPI: 1477039295
Provider Name (Legal Business Name): SHUNFA HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2018
Last Update Date: 07/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8811 GARVEY AVE STE 101E
ROSEMEAD CA
91770-2461
US

IV. Provider business mailing address

226 W LINDA VISTA AVE APT A
ALHAMBRA CA
91801-4775
US

V. Phone/Fax

Practice location:
  • Phone: 310-465-7533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: