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General NPI Number Information
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NPI Number | 1912592007
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Entity Type | Individual
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Provider Name | JODI HWANG
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Gender | Female
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 12/27/2025
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Provider Practice Location Address
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Address Line | 1200 N STATE ST CLINIC TOWER, SUITE A7D
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City | LOS ANGELES
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State | CA
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Zip | 90033-1029
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Country | US
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Telephone | 714-580-8086
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N STATE ST CLINIC TOWER, SUITE A7D
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City | LOS ANGELES
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State | CA
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Zip | 90033-1029
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Country | US
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Telephone | 714-580-8086
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 14197636-1205
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License Number State | UT
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