Provider Demographics
NPI:1376196097
Name:HUYNH, SANG (FNP)
Entity Type:Individual
Prefix:
First Name:SANG
Middle Name:
Last Name:HUYNH
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 GEMSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-1410
Mailing Address - Country:US
Mailing Address - Phone:210-913-8236
Mailing Address - Fax:
Practice Address - Street 1:23456 HAWTHORNE BLVD STE 140
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4716
Practice Address - Country:US
Practice Address - Phone:805-719-3700
Practice Address - Fax:805-413-9099
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141488363LF0000X
CANP95011755363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily