Provider Demographics
NPI:1073009171
Name:GRACE S HWANG MD INC
Entity Type:Organization
Organization Name:GRACE S HWANG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-202-5682
Mailing Address - Street 1:1010 W LA VETA AVE STE 470
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4305
Mailing Address - Country:US
Mailing Address - Phone:714-202-5682
Mailing Address - Fax:714-486-1411
Practice Address - Street 1:1010 W LA VETA AVE STE 470
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4305
Practice Address - Country:US
Practice Address - Phone:714-486-1411
Practice Address - Fax:714-835-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-02
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty