Healthcare Provider Details

I. General information

NPI: 1780654525
Provider Name (Legal Business Name): STANLEY HWANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 NEILSON ST STE 102
WATSONVILLE CA
95076-2491
US

IV. Provider business mailing address

65 NEILSON ST STE 102
WATSONVILLE CA
95076-2491
US

V. Phone/Fax

Practice location:
  • Phone: 831-768-6217
  • Fax: 831-768-6215
Mailing address:
  • Phone: 831-768-6217
  • Fax: 831-768-6215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG58772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: