Healthcare Provider Details

I. General information

NPI: 1699390773
Provider Name (Legal Business Name): DENIS HUANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 CEI DR
BLUE ASH OH
45242-5664
US

IV. Provider business mailing address

4860 Y ST STE 2400
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-5133
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35.150019
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT219903
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number35.150019
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: