Provider Demographics
NPI:1316491749
Name:JUDY C HUANG OPTOMETRY, INC
Entity type:Organization
Organization Name:JUDY C HUANG OPTOMETRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:562-924-7600
Mailing Address - Street 1:13005 ARTESIA BLVD
Mailing Address - Street 2:A110
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1356
Mailing Address - Country:US
Mailing Address - Phone:562-921-9888
Mailing Address - Fax:562-802-1888
Practice Address - Street 1:13005 ARTESIA BLVD
Practice Address - Street 2:A110
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1356
Practice Address - Country:US
Practice Address - Phone:562-921-9888
Practice Address - Fax:562-802-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT12155152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U96634Medicare UPIN