Healthcare Provider Details

I. General information

NPI: 1306899208
Provider Name (Legal Business Name): YU HWONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LAWRENCE Y. HWONG M.D.

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JOSE FIGUERES AVE STE 425
SAN JOSE CA
95116-1596
US

IV. Provider business mailing address

200 JOSE FIGUERES AVE STE 425
SAN JOSE CA
95116-1596
US

V. Phone/Fax

Practice location:
  • Phone: 408-998-1877
  • Fax: 408-998-1887
Mailing address:
  • Phone: 408-998-1877
  • Fax: 408-998-1887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG047398
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberG047398
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: