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General NPI Number Information
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NPI Number | 1629452131
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Entity Type | Organization
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Legal Business Name | PENG-YUN ANGELA HUANG, M.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 07/23/2015
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Provider Practice Location Address
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Address Line | 113 WATERWORKS WAY SUITE 110
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City | IRVINE
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State | CA
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Zip | 92618-3167
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Country | US
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Telephone | 949-393-5789
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Fax | 949-777-6168
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Provider Business Mailing Address
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Address Line | 113 WATERWORKS WAY SUITE 110
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City | IRVINE
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State | CA
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Zip | 92618-3167
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Country | US
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Telephone | 949-393-5789
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Fax | 949-777-6168
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA HUANG
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Credential | MD
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Telephone | 949-393-5789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 110931
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 110931
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License Number State | CA
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