Provider Demographics
NPI:1154325652
Name:HUANG, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 OLD SHORT HILLS ROAD
Mailing Address - Street 2:RADIATION ONCOLOGY
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-322-5630
Mailing Address - Fax:973-322-5648
Practice Address - Street 1:1225 WILSHIRE BLVD
Practice Address - Street 2:DEPARTMENT OF RADIATION ONCOLOGY
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1901
Practice Address - Country:US
Practice Address - Phone:213-977-2360
Practice Address - Fax:310-943-2703
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA641002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A641000OtherBLUE SHIELD
CA1154326562Medicaid
CA7228429OtherAETNA
CACE7706OtherRAILROAD MEDICARE
CACE7706OtherRAILROAD MEDICARE
CAH50684Medicare UPIN
CAWA64100J, K, L, M, NMedicare ID - Type Unspecified