Healthcare Provider Details

I. General information

NPI: 1487624284
Provider Name (Legal Business Name): STEVE HWANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 05/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 C ST
BAKERSFIELD CA
93301-3616
US

IV. Provider business mailing address

PO BOX 22437
SAINT LOUIS MO
63126-0437
US

V. Phone/Fax

Practice location:
  • Phone: 661-325-2640
  • Fax: 661-327-0816
Mailing address:
  • Phone: 661-325-2640
  • Fax: 661-327-0816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number04-24499
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number04-24499
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: