Healthcare Provider Details
I. General information
NPI: 1881492262
Provider Name (Legal Business Name): CHORNG-LII HWANG M.D PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
81709 DR CARREON BLVD STE B2
INDIO CA
92201-5510
US
IV. Provider business mailing address
81709 DR CARREON BLVD STE B2
INDIO CA
92201-5510
US
V. Phone/Fax
- Phone: 760-342-4771
- Fax: 760-342-2289
- Phone: 760-342-4771
- Fax: 760-342-2289
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHORNG LII
HWANG
Title or Position: PRESIDENT
Credential: MD
Phone: 760-342-4771