Provider Demographics
NPI:1841539111
Name:HEHWA CLINIC INC.
Entity type:Organization
Organization Name:HEHWA CLINIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-530-9115
Mailing Address - Street 1:1208 E ARQUES AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-5419
Mailing Address - Country:US
Mailing Address - Phone:408-530-9115
Mailing Address - Fax:408-530-9119
Practice Address - Street 1:1208 E ARQUES AVE STE 109
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-5419
Practice Address - Country:US
Practice Address - Phone:408-530-9115
Practice Address - Fax:408-530-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11474261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty