Edwin Kwon MD Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A107703 Issued in CA

Legal business name

EDWIN KWON MD INC

Practice address

520 S Kingsley Dr
Apt 205
Los Angeles, CA 90020-3504

Phone

(415) 533-4493

NPI assigned

Apr 15, 2016

Organization subpart

No

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

Authorized official

Name

Edwin Kwon, MDNPI 1326274788

Title

Owner

Phone

(415) 533-4493

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edwin Kwon, M.D.

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1326274788
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460678400000",
    "number": "1083068092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S KINGSLEY DR",
            "address_2": "APT 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S KINGSLEY DR",
            "address_2": "APT 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203504",
            "telephone_number": "415-533-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN KWON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2016-04-15",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-533-4493",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A107703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.