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NPI Code Detail

MEDICARE: MICHAELLA HWANG DDS

MEDICARE:   MICHAELLA  HWANG  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry48121CA

General Provider Information

NPI Number : 1164652145
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAELLA HWANG DDS
Provider Business Mailing Address
First Line : 4423 FIRST ST
Second Line :
City : LIVERMORE
State : CA
Zip : 94551-4915
Country : US
Telephone Number : 925-449-1768
Fax Number : 925-449-2065
Provider Business Practice Location Address
First Line : 4423 FIRST ST
Second Line :
City : LIVERMORE
State : CA
Zip : 94551-4915
Country : US
Telephone Number : 925-449-1768
Fax Number : 925-449-2065
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2009
Last Update Date : 07/23/2009

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