Provider Demographics
NPI:1073922969
Name:HWANG, SUNGSIM (L AC)
Entity Type:Individual
Prefix:MRS
First Name:SUNGSIM
Middle Name:
Last Name:HWANG
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9091 HOLDER ST #120
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630
Mailing Address - Country:US
Mailing Address - Phone:714-742-2283
Mailing Address - Fax:
Practice Address - Street 1:9091 HOLDER ST #120
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630
Practice Address - Country:US
Practice Address - Phone:714-742-2283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15756171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist