Provider Demographics
NPI:1629149505
Name:HUO, LICHUN (MD)
Entity type:Individual
Prefix:
First Name:LICHUN
Middle Name:
Last Name:HUO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5977 EAST SPRING ST.
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808
Mailing Address - Country:US
Mailing Address - Phone:657-241-8041
Mailing Address - Fax:657-276-4734
Practice Address - Street 1:5977 EAST SPRING ST.
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808
Practice Address - Country:US
Practice Address - Phone:657-241-8041
Practice Address - Fax:657-276-4734
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70626207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology