Provider Demographics
NPI:1609437599
Name:GINTIEN HUANG MD INC
Entity Type:Organization
Organization Name:GINTIEN HUANG MD INC
Other - Org Name:SAN BERNARDINO EYE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GINTIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-882-8829
Mailing Address - Street 1:1909 N WATERMAN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-4842
Mailing Address - Country:US
Mailing Address - Phone:908-882-8829
Mailing Address - Fax:
Practice Address - Street 1:1909 N WATERMAN AVE STE 3
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4842
Practice Address - Country:US
Practice Address - Phone:908-882-8829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-22
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty