Healthcare Provider Details

I. General information

NPI: 1821176587
Provider Name (Legal Business Name): AURORA GRACE E HWANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 SEQUOIA AVE
LINDSAY CA
93247-1424
US

IV. Provider business mailing address

835 SEQUOIA AVE
LINDSAY CA
93247-1424
US

V. Phone/Fax

Practice location:
  • Phone: 559-562-5177
  • Fax: 559-562-9284
Mailing address:
  • Phone: 559-562-5177
  • Fax: 559-562-9284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA40850
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: