Provider Demographics
NPI:1851346548
Name:WHANG, S. JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:S.
Middle Name:JOHN
Last Name:WHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3223 W 6TH ST
Mailing Address - Street 2:UNIT #1108
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-5005
Mailing Address - Country:US
Mailing Address - Phone:323-633-2399
Mailing Address - Fax:
Practice Address - Street 1:3223 W 6TH ST
Practice Address - Street 2:UNIT #1108
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-5005
Practice Address - Country:US
Practice Address - Phone:323-633-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92903207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H74159Medicare UPIN