Basic Information
Provider Information
NPI: 1871767244
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HWANG
FirstName: JOSEPH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 38467 5TH ST W
Address2: APT L195
City: PALMDALE
State: CA
PostalCode: 935514280
CountryCode: US
TelephoneNumber: 8185364922
FaxNumber:  
Practice Location
Address1: 43830 10TH ST W
Address2:  
City: LANCASTER
State: CA
PostalCode: 935344826
CountryCode: US
TelephoneNumber: 6619484781
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/16/2008
LastUpdateDate: 12/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XA97997CAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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