Provider Demographics
NPI:1093147712
Name:HUYNH, CRYSTAL (PA-C)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16027
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-6027
Mailing Address - Country:US
Mailing Address - Phone:949-574-4638
Mailing Address - Fax:949-574-4680
Practice Address - Street 1:520 SUPERIOR AVE STE 360
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3668
Practice Address - Country:US
Practice Address - Phone:949-644-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23135363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical