Healthcare Provider Details

I. General information

NPI: 1326686098
Provider Name (Legal Business Name): GING HAO HUANG L. AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2019
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14351 RED HILL AVE STE C
TUSTIN CA
92780-6271
US

IV. Provider business mailing address

9451 EL PUEBLO AVE
FOUNTAIN VALLEY CA
92708-4528
US

V. Phone/Fax

Practice location:
  • Phone: 714-580-3808
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number18768
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: