Individual provider Active NPI

Julia Wan-Chun Huang, O.D.

  • Optometrist
  • Monterey Park, CA
National Provider Identifier
1861618258
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12064T Issued in CA
Practice address
790 S Atlantic Blvd Ste 105
Monterey Park, CA 91754-3848
Phone
(626) 281-1062
Fax
(626) 289-8306
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12064T CA Primary

Addresses

Primary practice location

790 S Atlantic Blvd Ste 105
Monterey Park, CA 91754-3848

Mailing address

790 S Atlantic Blvd
Ste 105
Monterey Park, CA 91754-3848
Phone (626) 281-1062

Other identifiers 3

IdentifierTypeStateIssuer
1861618258OtherCANPI
1497971899OtherCAGROUP NPI
1861618258MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12064TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1861618258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 S ATLANTIC BLVD",
            "address_2": "STE 105",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917543848",
            "telephone_number": "626-281-1062",
            "fax_number": "626-289-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 S ATLANTIC BLVD STE 105",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917543848",
            "telephone_number": "626-281-1062",
            "fax_number": "626-289-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "JULIA",
        "middle_name": "WAN-CHUN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2021-04-06",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12064T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1861618258",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1497971899",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861618258",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.