Provider Demographics
NPI:1477611473
Name:HUANG, HARVEY M (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:M
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HARVEY
Other - Middle Name:M
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2089 PASEO NOCHE
Mailing Address - Street 2:6717 ARMITOS DR.
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-9371
Mailing Address - Country:US
Mailing Address - Phone:805-482-6479
Mailing Address - Fax:805-482-6479
Practice Address - Street 1:2089 PASEO NOCHE
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-9371
Practice Address - Country:US
Practice Address - Phone:805-341-4909
Practice Address - Fax:805-482-6479
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 31503207Q00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA 31503Medicare UPIN