Healthcare Provider Details

I. General information

NPI: 1962465567
Provider Name (Legal Business Name): SHARON JOSEPHINE WHANG D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N BEDFORD DR SUITE 107
BEVERLY HILLS CA
90210-4321
US

IV. Provider business mailing address

435 N BEDFORD DR SUITE 107
BEVERLY HILLS CA
90210-4321
US

V. Phone/Fax

Practice location:
  • Phone: 310-275-6969
  • Fax: 310-275-3814
Mailing address:
  • Phone: 310-275-6969
  • Fax: 310-275-3814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: