Individual provider Active NPI

Thomas C Huang, M.D.

  • Otolaryngology Physician
  • Tustin, CA
National Provider Identifier
1043201155
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G61652 Issued in CA
Practice address
2552 Walnut Ave
Ste 130
Tustin, CA 92780-6970
Phone
(714) 508-1600
Fax
(714) 312-1109
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G61652 CA Primary

Addresses

Primary practice location

2552 Walnut Ave
Ste 130
Tustin, CA 92780-6970

Mailing address

10197 Overhill Dr
Santa Ana, CA 92705
Phone (714) 878-6087

Other identifiers 1

IdentifierTypeStateIssuer
00G616520MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050321000667 CA Practitioner - Otolaryngology 4587619747 Practice locations: Tustin, CA

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, Geffen School of Medicine, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2552 Walnut Ave
Suite 130
Tustin, CA 92780-6970
Phone (714) 508-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G61652CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Global Medical Center, Inc Past Accepting new patients
Tison Medical Group Inc PastSince Sep 13, 2010 Accepting new patients
Chapman Medical Center Inc Past Accepting new patients
Buena Park Medical Group Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1043201155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10197 OVERHILL DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92705",
            "telephone_number": "714-878-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 WALNUT AVE",
            "address_2": "STE 130",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806970",
            "telephone_number": "714-508-1600",
            "fax_number": "714-312-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "THOMAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G61652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G616520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.