Healthcare Provider Details

I. General information

NPI: 1306841457
Provider Name (Legal Business Name): SARAH JENNIFER WHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 04/20/2020
Certification Date: 04/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 W LA VETA AVE STE 101
ORANGE CA
92866-2607
US

IV. Provider business mailing address

302 W LA VETA AVE STE 101
ORANGE CA
92866-2607
US

V. Phone/Fax

Practice location:
  • Phone: 714-633-0321
  • Fax: 714-633-9196
Mailing address:
  • Phone: 714-633-0321
  • Fax: 714-633-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License NumberC54031
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberC54031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: