Provider Demographics
NPI:1932260619
Name:KAMALANI, HEAJIN HWANG (MD)
Entity type:Individual
Prefix:
First Name:HEAJIN
Middle Name:HWANG
Last Name:KAMALANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEAJIN
Other - Middle Name:
Other - Last Name:HWANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5161 SOQUEL DR
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2560
Mailing Address - Country:US
Mailing Address - Phone:831-239-5866
Mailing Address - Fax:831-201-1281
Practice Address - Street 1:5161 SOQUEL DR STE C
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2560
Practice Address - Country:US
Practice Address - Phone:831-239-5866
Practice Address - Fax:831-201-1281
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72751207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G358690Medicaid
CA00G358690Medicaid
00G358690Medicare ID - Type Unspecified
CAA72751OtherDEA