=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568983971
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY HWANG PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2017
-----------------------------------------------------
Last Update Date | 12/17/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1800 HARRISON ST
-----------------------------------------------------
City | OAKLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94612-3466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-893-0420
-----------------------------------------------------
Fax | 866-475-9717
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4835 ROBERTS CT
-----------------------------------------------------
City | CASTRO VALLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94552-1700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-965-3794
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 75232
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------