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NPI Code Detail

MEDICARE: KENNETH YU-YEN HUANG MD

MEDICARE: KENNETH YU-YEN HUANG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianA73683CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200A736830 851OTHERCACAL OPTIMA

General Provider Information

NPI Number : 1366536419
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH YU-YEN HUANG MD
Provider Business Mailing Address
First Line : 444 W GLENOAKS BLVD
Second Line :
City : GLENDALE
State : CA
Zip : 91202-2917
Country : US
Telephone Number : 818-552-3120
Fax Number :
Provider Business Practice Location Address
First Line : 444 W GLENOAKS BLVD
Second Line :
City : GLENDALE
State : CA
Zip : 91202-2917
Country : US
Telephone Number : 818-552-3120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 12/01/2021

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