Provider Demographics
NPI:1750083085
Name:HWANG, NICOLE MINA (MPH)
Entity type:Individual
Prefix:
First Name:NICOLE MINA
Middle Name:
Last Name:HWANG
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:N. MINA
Other - Middle Name:
Other - Last Name:HWANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPH
Mailing Address - Street 1:11175 CAMPUS ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-6566
Mailing Address - Country:US
Mailing Address - Phone:253-777-9728
Mailing Address - Fax:
Practice Address - Street 1:11175 CAMPUS ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-6566
Practice Address - Country:US
Practice Address - Phone:253-777-9728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program