MEDICARE: DR. JULIA MARIE HENG 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
1	207Q00000X	Family Medicine Physician	C17206	CA
2	208000000X	Pediatrics Physician	C17206	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720175326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIA MARIE HENG MD

Provider Business Mailing Address
First Line	:	17456 BEACH BLVD
Second Line	:	101
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-5913
Country	:	US
Telephone Number	:	714-847-8551
Fax Number	:	562-592-5778

Provider Business Practice Location Address
First Line	:	17456 BEACH BLVD
Second Line	:	101
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-5913
Country	:	US
Telephone Number	:	714-847-8551
Fax Number	:	562-592-5778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	09/16/2010

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