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General NPI Number Information
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NPI Number | 1447676150
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Entity Type | Organization
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Legal Business Name | APOLLOGEN, INC.
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15375 BARRANCA PKWY # A105-106
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City | IRVINE
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State | CA
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Zip | 92618-2217
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Country | US
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Telephone | 949-916-8886
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50818
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City | IRVINE
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State | CA
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Zip | 92619-0818
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Country | US
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Telephone | 949-916-8886
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | DR. TAOSHENG HUANG
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Credential | M.D., PHD
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Telephone | 949-916-8886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 05D2055250
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License Number State | CA
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