Bohye Shelly Hwang-Betat, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A158825 Issued in CA

Practice address

570 S Mount Vernon Ave Ste G
San Bernardino, CA 92410-2737

Phone

(423) 243-4869

NPI assigned

May 11, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1386171106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 S MOUNT VERNON AVE STE G",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924102737",
            "telephone_number": "423-243-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 S MOUNT VERNON AVE STE G",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924102737",
            "telephone_number": "423-243-4869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 E Highland Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924043658",
            "country_code": "US",
            "telephone_number": "423-243-4869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11234 Anderson St",
            "address_2": "GME Office Westerly Suite 'C'",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HWANG-BETAT",
        "first_name": "BOHYE",
        "middle_name": "SHELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A158825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Hutchinson
• Kenny Huynh, OD
• Khanh N Huynh, PHARMD
• Phuc Tuan Huynh, D.O.
• Hwang Dental Corporation
• Daniel Kyung Hwang, M.D.
• Elyssa Hyde
• John Hynes, LMFT
• Hyun June Kim DDS Inc
• Hyung-Ju John Kim DDS Inc

• Pediatrics Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.