Healthcare Provider Details

I. General information

NPI: 1831085570
Provider Name (Legal Business Name): CLARE SOOJOUNG HWANG OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 YORBA LINDA BLVD
FULLERTON CA
92831-1615
US

IV. Provider business mailing address

746 VIA SAN SIMON
CLAREMONT CA
91711-1570
US

V. Phone/Fax

Practice location:
  • Phone: 714-449-7400
  • Fax:
Mailing address:
  • Phone: 909-767-8165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: