Provider Demographics
NPI:1689970592
Name:JIUNN-BOR JASON HWANG MD INC
Entity Type:Organization
Organization Name:JIUNN-BOR JASON HWANG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JIUNN-BOR
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-282-2118
Mailing Address - Street 1:850 S ATLANTIC BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-6708
Mailing Address - Country:US
Mailing Address - Phone:626-282-2118
Mailing Address - Fax:626-284-8395
Practice Address - Street 1:850 S ATLANTIC BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-6708
Practice Address - Country:US
Practice Address - Phone:626-282-2118
Practice Address - Fax:626-284-8395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA84122Medicare UPIN