Provider Demographics
NPI:1770814246
Name:HUANG, DE DONG DE DONG (AC)
Entity Type:Individual
Prefix:MR
First Name:DE DONG
Middle Name:DE DONG
Last Name:HUANG
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 EL CAMINO REAL #E
Mailing Address - Street 2:D.D.H. ACUPUNCTURE
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422
Mailing Address - Country:US
Mailing Address - Phone:805-460-9391
Mailing Address - Fax:
Practice Address - Street 1:8300 EL CAMINO REAL
Practice Address - Street 2:#E
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422
Practice Address - Country:US
Practice Address - Phone:805-460-9391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-24
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9570171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist