Basic Information
Provider Information
NPI: 1881928620
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUYNH
FirstName: HIEN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5700 SOUTHWYCK BLVD
Address2:  
City: TOLEDO
State: OH
PostalCode: 436141509
CountryCode: US
TelephoneNumber: 8002888325
FaxNumber: 4198665453
Practice Location
Address1: 2131 W 3RD ST
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900571901
CountryCode: US
TelephoneNumber: 2134847111
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/27/2009
LastUpdateDate: 03/07/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X116954CAY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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