Provider Demographics
NPI:1639495591
Name:IRVINE FAMILY CLINIC INC
Entity Type:Organization
Organization Name:IRVINE FAMILY CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-733-0168
Mailing Address - Street 1:18 ENDEAVOR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3164
Mailing Address - Country:US
Mailing Address - Phone:949-733-0168
Mailing Address - Fax:949-733-0161
Practice Address - Street 1:18 ENDEAVOR
Practice Address - Street 2:SUITE 203
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3164
Practice Address - Country:US
Practice Address - Phone:949-733-0168
Practice Address - Fax:949-733-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7467207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty