Healthcare Provider Details

I. General information

NPI: 1154592012
Provider Name (Legal Business Name): ALEXANDER HUANG MD A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 08/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 WASHINGTON BLVD
WHITTIER CA
90602-1006
US

IV. Provider business mailing address

PO BOX 3098
TORRANCE CA
90510-3098
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-0811
  • Fax:
Mailing address:
  • Phone: 310-792-3914
  • Fax: 310-792-3621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA69302
License Number StateCA

VIII. Authorized Official

Name: DR. ALEXANDER HUANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-792-3914