Individual ProviderVilayphone Thongsithavong HwangNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10833 Le Conte Ave Ste 32-263, Los Angeles, CA 90095-3075(310) 794-3170PECOS EnrollmentBased on the most recent information from CMS, provider Vilayphone Thongsithavong Hwang does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1629060157Provider TypeIndividualFull NameHwang, Vilayphone ThongsithavongCredentialPNPGenderFemaleSole ProprietorNoEnumeration Date8/19/2005Last Updated1/13/2009Contact InformationPractice LocationPractice Address10833 Le Conte Ave Ste 32-263, Los Angeles, CA 90095-3075Phone(310) 794-3170Fax(310) 794-3358Mailing LocationMailing Address10833 Le Conte Ave Ste 32-263, Los Angeles, CA 90095-3075Phone(310) 794-3170Fax(310) 794-3358Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense009005342California