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General NPI Number Information
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NPI Number | 1972124295
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Entity Type | Individual
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Provider Name | JAY HWANG MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2020
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 26520 CACTUS AVE
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City | MORENO VALLEY
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State | CA
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Zip | 92555-3927
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Country | US
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Telephone | 951-486-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 11234 ANDERSON ST GME OFFICE WESTERLY SUITE 'C'
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City | LOMA LINDA
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State | CA
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Zip | 92354-2804
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A178859
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License Number State | CA
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