Healthcare Provider Details

I. General information

NPI: 1679412399
Provider Name (Legal Business Name): ASHLEY HUYNH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 16TH ST
SANTA MONICA CA
90404-1235
US

IV. Provider business mailing address

757 WESTWOOD PLAZA, MEDICINE PEDIATRICS
LOS ANGELES CA
90095-7419
US

V. Phone/Fax

Practice location:
  • Phone: 310-315-8900
  • Fax:
Mailing address:
  • Phone: 424-946-5463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: