Provider Demographics
NPI:1538308549
Name:HWANG, JEE HWAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:JEE
Middle Name:HWAN
Last Name:HWANG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4722 AMALFI ST
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-3589
Mailing Address - Country:US
Mailing Address - Phone:714-220-7008
Mailing Address - Fax:
Practice Address - Street 1:3184 ARDEN WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3701
Practice Address - Country:US
Practice Address - Phone:916-486-5365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist