Provider Demographics
NPI:1578067484
Name:HUA, CHRISTIE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:HUA
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 1:495 E RINCON ST STE 215
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1378
Mailing Address - Country:US
Mailing Address - Phone:951-523-0117
Mailing Address - Fax:951-475-7013
Practice Address - Street 1:9939 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3528
Practice Address - Country:US
Practice Address - Phone:855-505-7467
Practice Address - Fax:888-975-8926
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA174113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine