Provider Demographics
NPI:1851325211
Name:HWANG, TZONG-YUEH (MD)
Entity Type:Individual
Prefix:DR
First Name:TZONG-YUEH
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12146 SOUTH STREET
Mailing Address - Street 2:UNIT B
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12146 SOUTH ST
Practice Address - Street 2:UNIT B
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-6844
Practice Address - Country:US
Practice Address - Phone:562-809-0288
Practice Address - Fax:562-403-2377
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48093207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A480930Medicaid
CAA48093Medicare ID - Type Unspecified
B69536Medicare UPIN