Provider Demographics
NPI:1801878954
Name:HWANG, DAVID K (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:HWANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 LOMBARD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-8223
Mailing Address - Country:US
Mailing Address - Phone:805-777-9277
Mailing Address - Fax:805-379-1964
Practice Address - Street 1:268 LOMBARD ST
Practice Address - Street 2:SUITE B
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8223
Practice Address - Country:US
Practice Address - Phone:805-777-9277
Practice Address - Fax:805-379-1964
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28498111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC28498Medicare ID - Type Unspecified
CAV05736Medicare UPIN