Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 46072 | CA |
N | 1223P0300X | Periodontist | 46072 | CA |
NPI | 1124242276 |
---|---|
Provider Name | Dr. Sheng Hao Huang |
First Address | Montebello, CA 90640-4603 |
Second Address | Montebello, CA 90640-4603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 01/12/2008 |