Provider Demographics
NPI:1174892004
Name:HUANG, SUZANNA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SUZANNA
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 BELRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4438
Mailing Address - Country:US
Mailing Address - Phone:909-632-3918
Mailing Address - Fax:
Practice Address - Street 1:1131 S GLENDORA AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-4955
Practice Address - Country:US
Practice Address - Phone:626-338-0904
Practice Address - Fax:626-338-4261
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist