Provider Demographics
NPI:1821176587
Name:HWANG, AURORA GRACE E
Entity Type:Individual
Prefix:
First Name:AURORA GRACE
Middle Name:E
Last Name:HWANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 SEQUOIA AVE
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:CA
Mailing Address - Zip Code:93247-1424
Mailing Address - Country:US
Mailing Address - Phone:559-562-5177
Mailing Address - Fax:559-562-9284
Practice Address - Street 1:835 SEQUOIA AVE
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-1424
Practice Address - Country:US
Practice Address - Phone:559-562-5177
Practice Address - Fax:559-562-9284
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40850208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A408500Medicaid
CA058930Medicare Oscar/Certification
CA00A408500Medicaid