Provider Demographics
NPI:1306919691
Name:HUANG, DAVID CHUN KANG (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHUN KANG
Last Name:HUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 VICTORIA ST
Mailing Address - Street 2:SUITE# 2B
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-1906
Mailing Address - Country:US
Mailing Address - Phone:949-722-6178
Mailing Address - Fax:949-722-6908
Practice Address - Street 1:275 VICTORIA ST
Practice Address - Street 2:SUITE# 2B
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-1906
Practice Address - Country:US
Practice Address - Phone:949-722-6178
Practice Address - Fax:949-722-6908
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44680207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A44680Medicaid
CA00A44680Medicaid
CAA44680Medicare ID - Type Unspecified