Healthcare Provider Details

I. General information

NPI: 1386245082
Provider Name (Legal Business Name): OC PULMONARY & SLEEP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2020
Last Update Date: 07/07/2021
Certification Date: 06/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BRYAN AVE STE E
TUSTIN CA
92780-4401
US

IV. Provider business mailing address

1101 BRYAN AVE STE E
TUSTIN CA
92780-4401
US

V. Phone/Fax

Practice location:
  • Phone: 714-922-0220
  • Fax: 714-922-0659
Mailing address:
  • Phone: 714-922-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CHIN-WEI HUANG
Title or Position: PRESIDENT
Credential: MD
Phone: 714-922-0220