Provider Demographics
NPI:1174601934
Name:HUANG, REGINA LINROL (MD)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:LINROL
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 UPLAND RD
Mailing Address - Street 2:
Mailing Address - City:NEWTONVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02460-2420
Mailing Address - Country:US
Mailing Address - Phone:510-579-3132
Mailing Address - Fax:
Practice Address - Street 1:181 UPLAND RD
Practice Address - Street 2:
Practice Address - City:NEWTONVILLE
Practice Address - State:MA
Practice Address - Zip Code:02460-2420
Practice Address - Country:US
Practice Address - Phone:510-579-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75382207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A753820Medicaid
00A753820Medicare ID - Type Unspecified
CA00A753820Medicaid