Healthcare Provider Details

I. General information

NPI: 1568614741
Provider Name (Legal Business Name): TSUNG YAO HUANG L.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2008
Last Update Date: 10/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 E VALLEY BLVD # 206
WEST COVINA CA
91792-3140
US

IV. Provider business mailing address

2707 E VALLEY BLVD # 206
WEST COVINA CA
91792-3140
US

V. Phone/Fax

Practice location:
  • Phone: 626-810-1199
  • Fax:
Mailing address:
  • Phone: 626-810-1199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number12753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: