Provider Demographics
NPI:1255430773
Name:HUANG, ARCH ZEN-SHIN (PA-C)
Entity type:Individual
Prefix:MR
First Name:ARCH
Middle Name:ZEN-SHIN
Last Name:HUANG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5560 BLUEJAY ST
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-2359
Mailing Address - Country:US
Mailing Address - Phone:909-593-9616
Mailing Address - Fax:
Practice Address - Street 1:11920 EAST GARVEY AVE.
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732
Practice Address - Country:US
Practice Address - Phone:626-350-2196
Practice Address - Fax:626-350-4030
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 14078363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical