Provider Demographics
NPI:1407800121
Name:HUANG, TZONG L
Entity Type:Individual
Prefix:DR
First Name:TZONG
Middle Name:L
Last Name:HUANG
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:THOMAS
Other - Middle Name:L
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1801 SOLAR DRIVE
Mailing Address - Street 2:#251,
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030
Mailing Address - Country:US
Mailing Address - Phone:805-988-6688
Mailing Address - Fax:805-981-9494
Practice Address - Street 1:1801 SOLAR DRIVE
Practice Address - Street 2:#251
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7652
Practice Address - Country:US
Practice Address - Phone:805-988-6688
Practice Address - Fax:805-981-9494
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33826207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0020840Medicaid
CAGR0020840Medicare ID - Type Unspecified
CAA84523Medicare UPIN