MEDICARE: POCHI HUANG O.D. INC.

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
1	152W00000X	Optometrist	13307T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13307T	OTHER	CA	CALIFORNIA STATE BOARD OF OPTOMETRY
2	1386892735	OTHER	CA	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1457630485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POCHI HUANG O.D. INC.

Provider Business Mailing Address
First Line	:	1520 BARONET PL
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92833-1501
Country	:	US
Telephone Number	:	714-773-4713
Fax Number	:	714-773-4713

Provider Business Practice Location Address
First Line	:	10515 VALLEY VIEW ST
Second Line	:
City	:	CYPRESS
State	:	CA
Zip	:	90630-4832
Country	:	US
Telephone Number	:	714-827-2020
Fax Number	:	714-827-2022

Authorized Official
Title or Position	:	OPTOMETRIST/PRESIDENT
Name	:	DR. POCHI HUANG
Credential	:	O.D.
Telephone Number	:	714-878-6551

Provider Enumeration Date	:	08/09/2011
Last Update Date	:	08/09/2011

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