1083717391 NPI number — HWE-SEUNG LUCY WHANG LEE MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083717391 NPI number — HWE-SEUNG LUCY WHANG LEE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEE
Provider First Name:
HWE-SEUNG
Provider Middle Name:
LUCY WHANG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHANG
Provider Other First Name:
HWE-SEUNG
Provider Other Middle Name:
LUCY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1083717391
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18406 ROSCOE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHRIDGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-885-8500
Provider Business Mailing Address Fax Number:
818-727-0793

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18406 ROSCOE BLVD
Provider Second Line Business Practice Location Address:
NORTHRIDGE FAMILY PRACTICE MEDICAL GROUP INC
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-885-8500
Provider Business Practice Location Address Fax Number:
818-727-0793
Provider Enumeration Date:
09/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  A068205 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A682050 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com