Healthcare Provider Details
I. General information
NPI: 1396362562
Provider Name (Legal Business Name): VIVIAN HUANG BUHLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/02/2020
Last Update Date: 07/02/2020
Certification Date: 07/02/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1115 S SUNSET AVE
WEST COVINA CA
91790-3940
US
IV. Provider business mailing address
1899 HOLLY TREE LN
SANTA ANA CA
92705-2579
US
V. Phone/Fax
- Phone: 888-456-2847
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: