Healthcare Provider Details

I. General information

NPI: 1699482109
Provider Name (Legal Business Name): OC PREMIER CARDIOLOGY AND VASCULAR INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5797 BEACH BLVD
BUENA PARK CA
90621-2044
US

IV. Provider business mailing address

3130 W OLYMPIC BLVD STE 250
LOS ANGELES CA
90006-2491
US

V. Phone/Fax

Practice location:
  • Phone: 714-760-9988
  • Fax:
Mailing address:
  • Phone: 213-528-1111
  • Fax: 213-528-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name: INYONG HWANG
Title or Position: DOCTOR
Credential:
Phone: 213-528-1111