Healthcare Provider Details
I. General information
NPI: 1710118658
Provider Name (Legal Business Name): MEI Z. HUANG O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/27/2009
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5080 FOOTHILLS BLVD STE. 2
ROSEVILLE CA
95747-6525
US
IV. Provider business mailing address
5080 FOOTHILLS BLVD STE. 2
ROSEVILLE CA
95747-6525
US
V. Phone/Fax
- Phone: 916-784-6508
- Fax: 916-784-8095
- Phone: 916-784-6508
- Fax: 916-784-8095
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 13718 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: