Provider Demographics
NPI:1104842319
Name:LUONG, HELEN H (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:H
Last Name:LUONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 W LA PALMA AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-3664
Mailing Address - Country:US
Mailing Address - Phone:714-535-8900
Mailing Address - Fax:714-778-1418
Practice Address - Street 1:1019 W LA PALMA AVE UNIT B
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-3664
Practice Address - Country:US
Practice Address - Phone:714-535-8900
Practice Address - Fax:714-778-1418
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55269207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A552690Medicaid
H17967Medicare UPIN
CA00A552690Medicaid