Provider Demographics
NPI:1841509049
Name:DAVID CHIEN-TA HWANG O.D.INC
Entity type:Organization
Organization Name:DAVID CHIEN-TA HWANG O.D.INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHIEN-TA
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-232-8952
Mailing Address - Street 1:13925 YALE AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2668
Mailing Address - Country:US
Mailing Address - Phone:949-726-1696
Mailing Address - Fax:949-726-1282
Practice Address - Street 1:13925 YALE AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-2668
Practice Address - Country:US
Practice Address - Phone:949-232-8952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT14044TLG261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAES736AMedicare PIN