Provider Demographics
NPI:1215128038
Name:HUANG, TIN-YUAN LO (OTR)
Entity type:Individual
Prefix:MRS
First Name:TIN-YUAN
Middle Name:LO
Last Name:HUANG
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-6528
Mailing Address - Country:US
Mailing Address - Phone:949-733-1841
Mailing Address - Fax:
Practice Address - Street 1:240 WESTWIND DR
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-6528
Practice Address - Country:US
Practice Address - Phone:949-733-1841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3722225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist