Provider Demographics
NPI:1619213485
Name:HUANG, DER-HOW (DPT, CSCS)
Entity Type:Individual
Prefix:MR
First Name:DER-HOW
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18376 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3502
Mailing Address - Country:US
Mailing Address - Phone:818-996-8386
Mailing Address - Fax:310-547-1972
Practice Address - Street 1:18376 CLARK ST
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3502
Practice Address - Country:US
Practice Address - Phone:818-996-8386
Practice Address - Fax:818-996-8979
Is Sole Proprietor?:No
Enumeration Date:2012-12-21
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist