Healthcare Provider Details

I. General information

NPI: 1811132012
Provider Name (Legal Business Name): JINSOOK HWANG L.AC, R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 WILSHIRE BLVD # 403
LOS ANGELES CA
90017-4810
US

IV. Provider business mailing address

1245 WILSHIRE BLVD # 403
LOS ANGELES CA
90017-4810
US

V. Phone/Fax

Practice location:
  • Phone: 562-644-1886
  • Fax: 213-482-4811
Mailing address:
  • Phone: 562-644-1886
  • Fax: 213-482-4811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC9443
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: