Provider Demographics
NPI:1588746911
Name:HUANG, CALEN (DMS)
Entity type:Individual
Prefix:
First Name:CALEN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:DMS
Other - Prefix:
Other - First Name:YU-CHIH
Other - Middle Name:
Other - Last Name:LIN HUANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMS
Mailing Address - Street 1:4232 VAN BUREN ST.
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710
Mailing Address - Country:US
Mailing Address - Phone:909-861-7350
Mailing Address - Fax:909-861-6170
Practice Address - Street 1:1135 SOUTH GRAND AVE
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765
Practice Address - Country:US
Practice Address - Phone:909-861-7350
Practice Address - Fax:909-861-6170
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8534171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist