Provider Demographics
NPI:1083941538
Name:HWANG, ELIZABETH T (DPT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:T
Last Name:HWANG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4427 TOMIK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1300
Mailing Address - Country:US
Mailing Address - Phone:626-534-1971
Mailing Address - Fax:323-464-5329
Practice Address - Street 1:321 N LARCHMONT BLVD
Practice Address - Street 2:SUITE #825
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-6400
Practice Address - Country:US
Practice Address - Phone:323-464-4458
Practice Address - Fax:323-464-5329
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist