Healthcare Provider Details

I. General information

NPI: 1326498742
Provider Name (Legal Business Name): HANALISE VANDEN EYKEL HUFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2016
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

5 CELESTE PL
ROLLING HILLS ESTATES CA
90274-4206
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-2343
  • Fax:
Mailing address:
  • Phone: 310-528-6533
  • 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: