Provider Demographics
NPI:1790954832
Name:HUANG, HELEN (OD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19746 LOS PINOS DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1724
Mailing Address - Country:US
Mailing Address - Phone:858-349-3031
Mailing Address - Fax:
Practice Address - Street 1:17251 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-9044
Practice Address - Country:US
Practice Address - Phone:909-355-3156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13460152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist