Provider Demographics
NPI:1326090010
Name:HUANG, BIH-JU RUBY (MD)
Entity Type:Individual
Prefix:DR
First Name:BIH-JU
Middle Name:RUBY
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BIH-JU
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:P.O. BOX 562
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272
Mailing Address - Country:US
Mailing Address - Phone:310-828-3500
Mailing Address - Fax:310-828-3501
Practice Address - Street 1:2216 SANTA MONICA BLVD
Practice Address - Street 2:SUITE #200
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-828-3500
Practice Address - Fax:310-828-3501
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37493208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A374930Medicaid
CA00A374930Medicaid
CA00A374930Medicaid