Provider Demographics
NPI:1588820518
Name:HUYNH, HELEN THAO (DO)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:THAO
Last Name:HUYNH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 SAN GABRIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2536
Mailing Address - Country:US
Mailing Address - Phone:626-773-8900
Mailing Address - Fax:626-940-5225
Practice Address - Street 1:3006 SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2536
Practice Address - Country:US
Practice Address - Phone:626-779-8900
Practice Address - Fax:626-940-5225
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10923207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70477FMedicaid
CAEC829ZMedicare PIN
CAEC829XMedicare PIN
CAFHC70477FMedicaid
CAW1508AMedicare PIN
EC829WMedicare PIN
CA051872Medicare Oscar/Certification
CAW1508Medicare PIN
CAW1508EMedicare PIN
CAW1508FMedicare PIN
CAW1508GMedicare PIN