Provider Demographics
NPI:1851696595
Name:HWANG, DIANA ESTHER (PA-C)
Entity Type:Individual
Prefix:
First Name:DIANA ESTHER
Middle Name:
Last Name:HWANG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:HWANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:218 KENSINGTON LN
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-7395
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4318 MAINE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3324
Practice Address - Country:US
Practice Address - Phone:818-857-8785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant