Provider Demographics
NPI:1073689105
Name:HUANG, YI NENG
Entity Type:Individual
Prefix:
First Name:YI
Middle Name:NENG
Last Name:HUANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3615
Mailing Address - Country:US
Mailing Address - Phone:626-293-1038
Mailing Address - Fax:
Practice Address - Street 1:27 W MAIN ST
Practice Address - Street 2:SUITE F
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3500
Practice Address - Country:US
Practice Address - Phone:626-570-4389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4447171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9946827Medicare ID - Type UnspecifiedMEDICARE