Healthcare Provider Details
I. General information
NPI: 1457544488
Provider Name (Legal Business Name): JULIE SOPHIA HWANG O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/22/2007
Last Update Date: 01/03/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
927 E ARQUES AVE STE 181
SUNNYVALE CA
94085-4533
US
IV. Provider business mailing address
927 E ARQUES AVE STE 181
SUNNYVALE CA
94085-4533
US
V. Phone/Fax
- Phone: 408-749-1530
- Fax:
- Phone: 408-749-1530
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WL0500X |
| Taxonomy | Low Vision Rehabilitation Optometrist |
| License Number | 1642 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 13254 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: