Provider Demographics
NPI:1598287104
Name:HWANG, PRECIOUS FAITH (OD)
Entity Type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:FAITH
Last Name:HWANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7592 SULLIVAN PL
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3200
Mailing Address - Country:US
Mailing Address - Phone:714-872-3442
Mailing Address - Fax:
Practice Address - Street 1:7592 SULLIVAN PL
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3200
Practice Address - Country:US
Practice Address - Phone:714-872-3442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33704TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist