Healthcare Provider Details

I. General information

NPI: 1356046049
Provider Name (Legal Business Name): IRENE HWANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 RALSTON ST
VENTURA CA
93003-7318
US

IV. Provider business mailing address

5250 RALSTON ST
VENTURA CA
93003-7318
US

V. Phone/Fax

Practice location:
  • Phone: 805-339-6400
  • Fax:
Mailing address:
  • Phone: 805-339-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35456
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: