Provider Demographics
NPI:1235334749
Name:HWANG, STEVEN KYONG WON (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:KYONG WON
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15303
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-0303
Mailing Address - Country:US
Mailing Address - Phone:213-675-7781
Mailing Address - Fax:
Practice Address - Street 1:903 CRENSHAW BLVD
Practice Address - Street 2:204
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-1964
Practice Address - Country:US
Practice Address - Phone:213-675-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA062230207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A622300Medicaid
CA00A622300Medicaid
A62230Medicare ID - Type Unspecified