Provider Demographics
NPI:1184014599
Name:HWANG, CHELINA S
Entity Type:Individual
Prefix:
First Name:CHELINA
Middle Name:S
Last Name:HWANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11797 PINE BROOK CT
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5113
Mailing Address - Country:US
Mailing Address - Phone:408-605-5010
Mailing Address - Fax:408-735-7575
Practice Address - Street 1:1208 E ARQUES AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-5418
Practice Address - Country:US
Practice Address - Phone:408-605-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16318171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist