Provider Demographics
NPI:1639120165
Name:HWANG, IL HOON DAVID (LIC ACU, OMD)
Entity Type:Individual
Prefix:MR
First Name:IL HOON
Middle Name:DAVID
Last Name:HWANG
Suffix:
Gender:M
Credentials:LIC ACU, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 S 4TH ST
Mailing Address - Street 2:SUITE A - EL CENTRO ACUPUNCTURE
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4742
Mailing Address - Country:US
Mailing Address - Phone:760-370-0516
Mailing Address - Fax:760-370-0516
Practice Address - Street 1:1121 S 4TH ST
Practice Address - Street 2:SUITE A - EL CENTRO ACUPUNCTURE
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4742
Practice Address - Country:US
Practice Address - Phone:760-370-0516
Practice Address - Fax:760-370-0516
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9704171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist