Provider Demographics
NPI:1083813158
Name:GALEN C. L. HUANG, M.D., INC.
Entity Type:Organization
Organization Name:GALEN C. L. HUANG, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GALEN
Authorized Official - Middle Name:CL
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-788-1450
Mailing Address - Street 1:6958 BROCKTON AVE # 202
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3802
Mailing Address - Country:US
Mailing Address - Phone:951-788-1450
Mailing Address - Fax:951-788-2385
Practice Address - Street 1:6958 BROCKTON AVE # 202
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3802
Practice Address - Country:US
Practice Address - Phone:951-788-1450
Practice Address - Fax:951-788-2385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG323540207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G323540Medicaid
CA00G323540Medicaid