Provider Demographics
NPI:1154984656
Name:HWANG, SANGWOO
Entity type:Individual
Prefix:
First Name:SANGWOO
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S VIRGIL AVE STE 222
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-4021
Mailing Address - Country:US
Mailing Address - Phone:213-249-6181
Mailing Address - Fax:213-302-2768
Practice Address - Street 1:621 S VIRGIL AVE STE 222
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-4000
Practice Address - Country:US
Practice Address - Phone:213-249-6181
Practice Address - Fax:213-302-2768
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17835171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist