Provider Demographics
NPI:1578871133
Name:HWANG, DAVID CHIEN-TA (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CHIEN-TA
Last Name:HWANG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 E LINCOLN AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1909
Mailing Address - Country:US
Mailing Address - Phone:949-726-1696
Mailing Address - Fax:949-551-9320
Practice Address - Street 1:1122 E LINCOLN AVE STE 206
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1909
Practice Address - Country:US
Practice Address - Phone:714-889-9689
Practice Address - Fax:949-726-1282
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT14044TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist