MEDICARE: DAVID CHIEN-TA HWANG O.D

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
1	152W00000X	Optometrist	OPT14044TLG	CA

General Provider Information

NPI Number	:	1578871133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CHIEN-TA HWANG O.D

Provider Business Mailing Address
First Line	:	1122 E LINCOLN AVE STE 206
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92865-1909
Country	:	US
Telephone Number	:	949-726-1696
Fax Number	:	949-551-9320

Provider Business Practice Location Address
First Line	:	1122 E LINCOLN AVE STE 206
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92865-1909
Country	:	US
Telephone Number	:	714-889-9689
Fax Number	:	949-726-1282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2010
Last Update Date	:	04/29/2022

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