Provider Demographics
NPI:1255692349
Name:MAK-HUANG, ROWENA KAI LING (MD)
Entity Type:Individual
Prefix:DR
First Name:ROWENA
Middle Name:KAI LING
Last Name:MAK-HUANG
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 1:11441 HEACOCK ST STE C
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-7907
Mailing Address - Country:US
Mailing Address - Phone:951-247-5809
Mailing Address - Fax:
Practice Address - Street 1:11441 HEACOCK ST STE C
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-7907
Practice Address - Country:US
Practice Address - Phone:951-247-5809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA126453208000000X, 207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine