Healthcare Provider Details

I. General information

NPI: 1326547209
Provider Name (Legal Business Name): MS. CHI YING HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S SAN GABRIEL BLVD STE 138
SAN GABRIEL CA
91776-3160
US

IV. Provider business mailing address

1039 W ROSES RD
SAN GABRIEL CA
91775-2126
US

V. Phone/Fax

Practice location:
  • Phone: 626-215-2153
  • Fax:
Mailing address:
  • Phone: 626-215-2153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number15592
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: