Individual provider Active NPI

Aurora Grace E Hwang

  • Pediatrics Physician
  • Lindsay, CA
National Provider Identifier
1821176587
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A40850 Issued in CA
Practice address
835 Sequoia Ave
Lindsay, CA 93247-1424
Phone
(559) 562-5177
Fax
(559) 562-9284
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A40850 CA Primary

Addresses

Primary practice location

835 Sequoia Ave
Lindsay, CA 93247-1424

Mailing address

835 Sequoia Ave
Lindsay, CA 93247-1424
Phone (559) 562-5177

Other identifiers 1

IdentifierTypeStateIssuer
00A408500MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081119000226 CA Part A Provider - Rural Health Clinic 3375603442 Practice locations: Lindsay, CA

Rural health clinic certification: CCN 058930

Legal name
AURORA GRACE E HWANG
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 3, 2008
Last certification
May 25, 2017
Ownership / control type
1A
Organization structure
Sole ProprietorProprietary
Enrollment address
835 Sequoia Ave
Lindsay, CA 93247-1424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A40850CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green Valley Medical Corporation Past Accepting new patients
A Grace E Hwang Past Accepting new patients
Grace Hwang MD Inc Pediatrics Past Accepting new patients

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Aurora Grace E Hwang Individual 5% Or Greater Direct Ownership InterestOwner Dec 6, 2006 100%
W-2 Managing EmployeeOwner Dec 6, 2006

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1821176587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SEQUOIA AVE",
            "city": "LINDSAY",
            "state": "CA",
            "postal_code": "932471424",
            "telephone_number": "559-562-5177",
            "fax_number": "559-562-9284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 SEQUOIA AVE",
            "city": "LINDSAY",
            "state": "CA",
            "postal_code": "932471424",
            "telephone_number": "559-562-5177",
            "fax_number": "559-562-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HWANG",
        "first_name": "AURORA GRACE",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A40850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A408500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindsay, CA

Sources for this page

Verify at the official NPI Registry.