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General NPI Number Information
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NPI Number | 1063679421
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Entity Type | Organization
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Legal Business Name | PETER D HUANG, O.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 557 H ST SUITE B
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City | CHULA VISTA
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State | CA
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Zip | 91910-4330
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Country | US
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Telephone | 619-422-0139
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Fax | 619-422-0066
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Provider Business Mailing Address
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Address Line | 557 H ST SUITE B
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City | CHULA VISTA
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State | CA
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Zip | 91910-4330
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Country | US
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Telephone | 619-422-0139
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Fax | 619-422-0066
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER D HUANG
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Credential | O.D.
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Telephone | 619-422-0139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | CA11659T
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License Number State | CA
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