Provider Demographics
NPI:1427286343
Name:HWANG, NINA XIAO (MD)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:XIAO
Last Name:HWANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:X
Other - Last Name:LUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:701 SOUTH PARKER STREET
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4306
Mailing Address - Country:US
Mailing Address - Phone:714-221-1200
Mailing Address - Fax:714-221-1299
Practice Address - Street 1:701 SOUTH PARKER STREET
Practice Address - Street 2:SUITE 1000
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-221-1200
Practice Address - Fax:714-221-1299
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1078792080P0207X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1427286343Medicaid
CA1427286343Medicaid