Provider Demographics
NPI:1134449382
Name:HWANG, LISA H (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:H
Last Name:HWANG
Suffix:
Gender:F
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:THE PLASTIC SURGERY CENTER
Mailing Address - Street 2:95 SCRIPPS DRIVE
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-929-1833
Mailing Address - Fax:916-929-6730
Practice Address - Street 1:THE PLASTIC SURGERY CENTER
Practice Address - Street 2:95 SCRIPPS DRIVE
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-929-1833
Practice Address - Fax:916-929-6730
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192785282N00000X
CAC155248261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No282N00000XHospitalsGeneral Acute Care Hospital