Provider Demographics
NPI:1588146302
Name:HUA, ANA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:HUA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANH
Other - Middle Name:
Other - Last Name:HUA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:418 E LAS TUNAS DR UNIT 3G
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-5506
Mailing Address - Country:US
Mailing Address - Phone:626-571-8660
Mailing Address - Fax:844-270-2240
Practice Address - Street 1:842 E MISSION RD STE C
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2761
Practice Address - Country:US
Practice Address - Phone:626-571-8660
Practice Address - Fax:844-270-2240
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL9582171W00000X, 174400000X, 247200000X, 374700000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
No374700000XNursing Service Related ProvidersTechnicianGroup - Multi-Specialty