Provider Demographics
NPI:1548887516
Name:HUYNH, CHAU NGOC BAO
Entity type:Individual
Prefix:
First Name:CHAU
Middle Name:NGOC BAO
Last Name:HUYNH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 S PARTON ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-1630
Mailing Address - Country:US
Mailing Address - Phone:657-298-6024
Mailing Address - Fax:
Practice Address - Street 1:1350 SE MAYNARD RD STE 203
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3634
Practice Address - Country:US
Practice Address - Phone:800-218-1405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist