Healthcare Provider Details

I. General information

NPI: 1508061300
Provider Name (Legal Business Name): EDMUND HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CEDARS-SINAI COMPREHENSIVE TRANSPLANT CENTER 8900 BEVERLY BOULEVARD, 2ND FLOOR
WEST HOLLYWOOD CA
90048
US

IV. Provider business mailing address

2000 BELMONT LN
REDONDO BEACH CA
90278-4908
US

V. Phone/Fax

Practice location:
  • Phone: 310-248-6528
  • Fax: 310-423-4678
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA81770
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD06601
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberD06601
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA81770
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: