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3727 W 6th St Ste 602, Los Angeles, CA 90020-5111 | |
(213) 388-7822 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Physical Therapist |
Location | 3727 W 6th St Ste 602, Los Angeles, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1255381745 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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171100000X | Acupuncturist | AC9737 (California) | Secondary |
225100000X | Physical Therapist | PT23721 (California) | Primary |
Provider Name | Soo H Kwon |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1952352403 PECOS PAC ID: 5890782833 Enrollment ID: I20040429001352 |
Mailing Address | Practice Location Address |
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3727 W 6th St Ste 602, Los Angeles, CA 90020-5111 Ph: (213) 388-7822 | 3727 W 6th St Ste 602, Los Angeles, CA 90020-5111 Ph: (213) 388-7822 |