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General NPI Number Information
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NPI Number | 1275906950
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Entity Type | Individual
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Provider Name | JENNIE HUANG
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Gender | Female
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Dates
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Enumeration Date | 11/03/2015
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 1550 PUENTE AVE
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City | BALDWIN PARK
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State | CA
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Zip | 91706-5923
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Country | US
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Telephone | 626-814-1483
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Fax | 626-814-1493
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Provider Business Mailing Address
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Address Line | 2265 SHADY OAKS RD
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City | GLENDORA
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State | CA
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Zip | 91741-4605
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 48513
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License Number State | CA
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