Provider Demographics
NPI:1679850143
Name:HWANG, KYU SUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:KYU SUNG
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ODYSSEY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-7700
Mailing Address - Country:US
Mailing Address - Phone:949-336-8201
Mailing Address - Fax:
Practice Address - Street 1:22 ODYSSEY
Practice Address - Street 2:SUITE 230
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3186
Practice Address - Country:US
Practice Address - Phone:949-336-8201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31615111N00000X
CA14513171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist