Provider Demographics
NPI:1811407331
Name:HWANG, MICHELE HEE (NP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:HEE
Last Name:HWANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 ANACAPA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2331
Mailing Address - Country:US
Mailing Address - Phone:213-910-6760
Mailing Address - Fax:
Practice Address - Street 1:2216 ANACAPA
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-2331
Practice Address - Country:US
Practice Address - Phone:213-910-6760
Practice Address - Fax:213-910-6760
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027465163W00000X
CA95006983363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse