Healthcare Provider Details
I. General information
NPI: 1053998823
Provider Name (Legal Business Name): JOHN HOJOON HWANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/26/2021
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
550 16TH ST. FLOOR 4, BOX 0110
SAN FRANCISCO CA
94143
US
IV. Provider business mailing address
550 16TH ST. FLOOR 4, BOX 0110
SAN FRANCISCO CA
94143
US
V. Phone/Fax
- Phone: 949-241-4062
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A193983 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: