Healthcare Provider Details

I. General information

NPI: 1134449382
Provider Name (Legal Business Name): LISA H. HWANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THE PLASTIC SURGERY CENTER 95 SCRIPPS DRIVE
SACRAMENTO CA
95825
US

IV. Provider business mailing address

THE PLASTIC SURGERY CENTER 95 SCRIPPS DRIVE
SACRAMENTO CA
95825
US

V. Phone/Fax

Practice location:
  • Phone: 916-929-1833
  • Fax: 916-929-6730
Mailing address:
  • Phone: 916-929-1833
  • Fax: 916-929-6730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberC155248
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberMT192785
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: