Provider Demographics
NPI:1336201482
Name:A GRACE E HWANG
Entity type:Organization
Organization Name:A GRACE E HWANG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AURORA GRACE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-562-5177
Mailing Address - Street 1:835 SEQUOIA AVE
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:CA
Mailing Address - Zip Code:93247-1424
Mailing Address - Country:US
Mailing Address - Phone:559-562-5177
Mailing Address - Fax:559-562-9284
Practice Address - Street 1:835 SEQUOIA AVE
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-1424
Practice Address - Country:US
Practice Address - Phone:559-562-5177
Practice Address - Fax:559-562-9284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health