MEDICARE: ING-JUN HWANG DACM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	19719	CA

General Provider Information

NPI Number	:	1942983556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ING-JUN HWANG DACM

Provider Business Mailing Address
First Line	:	4052 CLAIREMONT DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-5522
Country	:	US
Telephone Number	:	619-339-7079
Fax Number	:

Provider Business Practice Location Address
First Line	:	4052 CLAIREMONT DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-5522
Country	:	US
Telephone Number	:	619-339-7079
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2023
Last Update Date	:	12/12/2023

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