Provider Demographics
NPI:1104678077
Name:HWANG, IN SANG (PHARMD)
Entity type:Individual
Prefix:
First Name:IN SANG
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:
Other - Last Name:HWANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6545 GROTTO LN UNIT 2
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-5571
Mailing Address - Country:US
Mailing Address - Phone:323-823-5006
Mailing Address - Fax:
Practice Address - Street 1:6405 DAY ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0901
Practice Address - Country:US
Practice Address - Phone:951-899-8188
Practice Address - Fax:951-899-8189
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist