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General NPI Number Information
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NPI Number | 1093225328
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Entity Type | Individual
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Provider Name | KYUCHUL DAVID HWANG
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Gender | Male
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Dates
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Enumeration Date | 09/29/2017
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Last Update Date | 09/29/2017
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Provider Practice Location Address
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Address Line | 2528 W OLYMPIC BLVD # 110-111
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City | LOS ANGELES
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State | CA
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Zip | 90006-2922
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Country | US
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Telephone | 213-387-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 63 GENTRY
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City | IRVINE
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State | CA
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Zip | 92620-2835
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 102066
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License Number State | CA
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