| Edwin Kwon Md Inc | |
|
520 S Kingsley Dr Apt 205 Los Angeles CA 90020-3504 | |
| (415) 533-4493 | |
| Not Available |
| Full Name | Edwin Kwon Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 520 S Kingsley Dr, Los Angeles, California |
| Authorized Official Name and Position | Edwin Kwon (OWNER) |
| Authorized Official Contact | 4155334493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edwin Kwon Md Inc 520 S Kingsley Dr Apt 205 Los Angeles CA 90020-3504 Ph: () - | Edwin Kwon Md Inc 520 S Kingsley Dr Apt 205 Los Angeles CA 90020-3504 Ph: (415) 533-4493 |
| NPI Number | 1083068092 |
|---|---|
| Provider Enumeration Date | 04/15/2016 |
| Last Update Date | 04/15/2016 |
| Medicare PECOS PAC ID | 7517256407 |
|---|---|
| Medicare Enrollment ID | O20160517000162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083068092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A107703 (California) | Primary |
| Provider Name | Edwin S Kwon |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1326274788 PECOS PAC ID: 9234428129 Enrollment ID: I20160517000264 |
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