Provider Demographics
NPI:1699306688
Name:HWANG, PETER GENE (MA APCC 18882)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:GENE
Last Name:HWANG
Suffix:
Gender:
Credentials:MA APCC 18882
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 LONG BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3941
Mailing Address - Country:US
Mailing Address - Phone:562-498-5500
Mailing Address - Fax:
Practice Address - Street 1:3545 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3941
Practice Address - Country:US
Practice Address - Phone:562-498-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4896101YM0800X
CA18882101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health