Healthcare Provider Details

I. General information

NPI: 1902725674
Provider Name (Legal Business Name): JOSEPH HUYNH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8627 ATLANTIC AVE
SOUTH GATE CA
90280-3501
US

IV. Provider business mailing address

5320 AVENIDA DE DESPACIO
YORBA LINDA CA
92887-4001
US

V. Phone/Fax

Practice location:
  • Phone: 888-499-9303
  • Fax: 323-597-2184
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: