Individual provider Active NPI

Grace Hwang, M.D.

  • Family Medicine Physician
  • Redondo Beach, CA
National Provider Identifier
1508971243
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A80874 Issued in CA
Practice address
520 N Prospect Ave Ste 103
Redondo Beach, CA 90277-3033
Phone
(310) 376-8816
Fax
(310) 374-2806
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A80874 CA Primary

Addresses

Primary practice location

520 N Prospect Ave Ste 103
Redondo Beach, CA 90277-3033

Mailing address

520 N Prospect Ave Ste 103
Redondo Beach, CA 90277-3033
Phone (310) 376-8816

Other identifiers 1

IdentifierTypeStateIssuer
00A808740MedicaidCA

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address ghwang196673@oc.providencedirect.org
Direct Messaging Address ghwang196673@oc.providencedirect.org
Direct Messaging Address ghwang196673@oc.providencedirect.org
Direct Messaging Address ghwang196673@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040809001497 CA Practitioner - Family Practice 8426020595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

1010 N Sepulveda Blvd
Manhattan Beach, CA 90266-5929
Phone (310) 376-6262

Hospital & facility affiliations

  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353
  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Family Medicine CurrentSince May 18, 2008 Accepting new patients
Providence Medical Institute Family Medicine Current Accepting new patients
Providence Medical Institute Family Medicine CurrentSince May 18, 2008 Accepting new patients
Providence Health System Southern California Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

1010 N Sepulveda Blvd
Manhattan Beach, CA 90266
Phone (310) 322-9700

520 N Prospect Ave
Ste 102
Redondo Beach, CA 90277
Phone (310) 318-9992

520 N Prospect Ave
Ste 103
Redondo Beach, CA 90277
Phone (310) 374-9646

3330 Lomita Blvd
Torrance, CA 90505
Phone (310) 517-4675

4201 Torrance Blvd
Ste 260
Torrance, CA 90503
Phone (424) 212-5333

2382 Crenshaw Blvd
Ste 5
Torrance, CA 90501
Phone (310) 618-6200

21311 Madrona Ave
Ste 100A
Torrance, CA 90503
Phone (310) 792-4400

21311 Madrona Ave
Ste 101
Torrance, CA 90503
Phone (310) 792-4012

20911 Earl St
Ste 440
Torrance, CA 90503
Phone (310) 419-8585

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ghwang196673@oc.providencedirect.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1508971243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE STE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773033",
            "telephone_number": "310-376-8816",
            "fax_number": "310-374-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE STE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773033",
            "telephone_number": "310-376-8816",
            "fax_number": "310-374-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HWANG",
        "first_name": "GRACE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A80874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A808740",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ghwang196673@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "520 N Prospect Ave Ste 103",
            "city": "Redondo Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902773033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ghwang196673@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2382 Crenshaw Blvd Ste 5",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905013333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ghwang196673@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4201 Torrance Blvd Ste 260",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905034534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ghwang196673@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "520 N Prospect Ave Ste 102",
            "city": "Redondo Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902773033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.