Healthcare Provider Details

I. General information

NPI: 1689970592
Provider Name (Legal Business Name): JIUNN-BOR JASON HWANG MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 02/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 S ATLANTIC BLVD STE 204
MONTEREY PARK CA
91754-6708
US

IV. Provider business mailing address

850 S ATLANTIC BLVD STE 204
MONTEREY PARK CA
91754-6708
US

V. Phone/Fax

Practice location:
  • Phone: 626-282-2118
  • Fax: 626-284-8395
Mailing address:
  • Phone: 626-282-2118
  • Fax: 626-284-8395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: JIUNN-BOR JASON HWANG
Title or Position: MD
Credential:
Phone: 626-282-2118