Healthcare Provider Details

I. General information

NPI: 1598900680
Provider Name (Legal Business Name): STEVE CHIA HUANG D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 SANTA MONICA BLVD
SANTA MONICA CA
90404-2555
US

IV. Provider business mailing address

3011 SANTA MONICA BLVD
SANTA MONICA CA
90404-2555
US

V. Phone/Fax

Practice location:
  • Phone: 310-829-1559
  • Fax: 310-828-7383
Mailing address:
  • Phone: 310-829-1559
  • Fax: 310-828-7383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number57306
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: