Healthcare Provider Details

I. General information

NPI: 1740427624
Provider Name (Legal Business Name): SUNG HWAN HWANG L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 02/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11960 ARTESIA BLVD STE 102
ARTESIA CA
90701-4093
US

IV. Provider business mailing address

11960 ARTESIA BLVD STE 102
ARTESIA CA
90701-4093
US

V. Phone/Fax

Practice location:
  • Phone: 562-860-0242
  • Fax:
Mailing address:
  • Phone: 562-860-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number12771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: