Provider Demographics
NPI:1093883217
Name:HUANG, VIVIAN HY (LAC)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:HY
Last Name:HUANG
Suffix:
Gender:F
Credentials:LAC
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Mailing Address - Street 1:8896 SOUTHSIDE AVE
Mailing Address - Street 2:#C
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2231
Mailing Address - Country:US
Mailing Address - Phone:916-714-6802
Mailing Address - Fax:916-714-6803
Practice Address - Street 1:8896 SOUTHSIDE AVE
Practice Address - Street 2:#C
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2231
Practice Address - Country:US
Practice Address - Phone:916-714-6802
Practice Address - Fax:916-714-6803
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2013-01-22
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Provider Licenses
StateLicense IDTaxonomies
CAAC7301204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM