Provider Demographics
NPI:1417253147
Name:HUANG, KENNY KEUI-HSIANG (DPM)
Entity Type:Individual
Prefix:DR
First Name:KENNY
Middle Name:KEUI-HSIANG
Last Name:HUANG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 LEAGUE UNIT 61200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-7054
Mailing Address - Country:US
Mailing Address - Phone:626-869-8769
Mailing Address - Fax:949-579-2069
Practice Address - Street 1:855 N LARK ELLEN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1099
Practice Address - Country:US
Practice Address - Phone:626-869-8769
Practice Address - Fax:949-579-2069
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4929213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery