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General NPI Number Information
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NPI Number | 1205395639
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Entity Type | Individual
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Provider Name | CHENG HSU HUANG DDS
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Gender | Male
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 1461 W GRAND AVE
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City | GROVER BEACH
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State | CA
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Zip | 93433-2287
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Country | US
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Telephone | 805-598-0519
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Fax |
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Provider Business Mailing Address
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Address Line | 1253 W EL CAMINO REAL STE B
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City | SUNNYVALE
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State | CA
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Zip | 94087-1063
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Country | US
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Telephone | 805-598-0519
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 64376
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License Number State | CA
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