Provider Demographics
NPI:1629258892
Name:HUANG, AUDREY HEE (MD)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:HEE
Last Name:HUANG
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 1:7225 CRESCENT PARK W
Mailing Address - Street 2:#239
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2718
Mailing Address - Country:US
Mailing Address - Phone:310-316-0916
Mailing Address - Fax:
Practice Address - Street 1:2840 LONG BEACH BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1516
Practice Address - Country:US
Practice Address - Phone:562-424-8111
Practice Address - Fax:562-424-8363
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94259208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation