Provider Demographics
NPI:1578685095
Name:HUANG, LAURA (L AC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23361 EL TORO RD STE 106
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4810
Mailing Address - Country:US
Mailing Address - Phone:949-855-8119
Mailing Address - Fax:
Practice Address - Street 1:23361 EL TORO RD STE 106
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4810
Practice Address - Country:US
Practice Address - Phone:949-855-8119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 5374171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist