Provider Demographics
NPI:1831948850
Name:HUYNH, CHAU G
Entity type:Individual
Prefix:
First Name:CHAU
Middle Name:G
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 1:823 BURNS CIR NW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3501
Mailing Address - Country:US
Mailing Address - Phone:678-549-8386
Mailing Address - Fax:
Practice Address - Street 1:4855 RIVER GREEN PKWY STE 620
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8339
Practice Address - Country:US
Practice Address - Phone:678-549-8386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
X8X9X5C2246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy