Healthcare Provider Details

I. General information

NPI: 1568511061
Provider Name (Legal Business Name): EMILY HUANG D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13044 SIGNATURE PT APT 34
SAN DIEGO CA
92130-1549
US

IV. Provider business mailing address

13044 SIGNATURE PT APT 34
SAN DIEGO CA
92130-1549
US

V. Phone/Fax

Practice location:
  • Phone: 917-306-4988
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number0102201958
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: