Provider Demographics
NPI:1528003514
Name:HUANG, PATTY (MD)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 VISTA LESINA
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657
Mailing Address - Country:US
Mailing Address - Phone:657-241-3359
Mailing Address - Fax:
Practice Address - Street 1:1 HOAG DR.
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663
Practice Address - Country:US
Practice Address - Phone:949-574-4694
Practice Address - Fax:949-574-4680
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66914207R00000X
CAA66918208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00467617OtherMEDICARE RAILROAD
CAWA66914BMedicare PIN