Healthcare Provider Details

I. General information

NPI: 1861339327
Provider Name (Legal Business Name): YOUNG SUN HWANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1385 S DIAMOND BAR BLVD
DIAMOND BAR CA
91765-2208
US

IV. Provider business mailing address

807 CONCORD AVE
FULLERTON CA
92831-3513
US

V. Phone/Fax

Practice location:
  • Phone: 909-274-7286
  • Fax:
Mailing address:
  • Phone: 213-703-1810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: