Healthcare Provider Details

I. General information

NPI: 1477624625
Provider Name (Legal Business Name): MICHAEL E HUK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S MELROSE DR SUITE 104
VISTA CA
92081-6642
US

IV. Provider business mailing address

999 N PACIFIC ST APT. B313
OCEANSIDE CA
92054-2005
US

V. Phone/Fax

Practice location:
  • Phone: 760-940-4055
  • Fax: 760-940-4084
Mailing address:
  • Phone: 760-712-6773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberA61487
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA61487
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberA61487
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberA61487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: