Bum Won Kwak, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

966 S Westmoreland Ave Apt 1
Los Angeles, CA 90006-5611

Phone

(315) 804-1825

NPI assigned

May 10, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Epic Wound Care Inc

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Westlake Village, CA
  • NPI 1265248413
  Medicare reassignment

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

{
    "created_epoch": "1746835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746835200000",
    "number": "1093505257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 S WESTMORELAND AVE APT 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900065611",
            "telephone_number": "315-804-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 S WESTMORELAND AVE APT 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900065611",
            "telephone_number": "315-804-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "BUM",
        "middle_name": "WON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-10",
        "last_updated": "2025-05-10",
        "certification_date": "2025-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Kwabla, LVN
• Jin Gon Kwack, ACUPUNCTURIST
• Jaewon Kwag
• Juliann Kwak Lee, M.D.
• Angie Kwak
• Christina Kwak, DPT
• Jamie Kwak
• Judy Kwak
• Kay Kwak
• Ke Sung Kwak, D.C.

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.