Provider Demographics
NPI:1508036617
Name:HUANG, ANNIE YI-HWA (PA)
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:YI-HWA
Last Name:HUANG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E CALIFORNIA BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3944
Mailing Address - Country:US
Mailing Address - Phone:626-793-1227
Mailing Address - Fax:626-793-3794
Practice Address - Street 1:55 E CALIFORNIA BLVD FL 3
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3944
Practice Address - Country:US
Practice Address - Phone:626-793-1227
Practice Address - Fax:626-793-3794
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1035691363AM0700X
CAPA18285363AM0700X
CAPA 18285363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA 18285OtherPA COMMITTEE
CA1035691OtherNCCPA