Provider Demographics
NPI:1861618258
Name:HUANG, JULIA WAN-CHUN (OD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:WAN-CHUN
Last Name:HUANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 S ATLANTIC BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-3848
Mailing Address - Country:US
Mailing Address - Phone:626-281-1062
Mailing Address - Fax:626-289-8306
Practice Address - Street 1:790 S ATLANTIC BLVD STE 105
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-3848
Practice Address - Country:US
Practice Address - Phone:626-281-1062
Practice Address - Fax:626-289-8306
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12064T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1861618258OtherNPI
CA1497971899OtherGROUP NPI
CA1861618258Medicaid