Active NPI
Kevin V Kwok
- Pharmacist
- San Leandro, CA
National Provider Identifier
1174806723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 54704
- Practice address
- 1456 136TH Ave
San Leandro, CA 94578-2552 - Phone
- (510) 618-1504
- NPI assigned
- Sep 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 54704 | CA | Primary |
Addresses
Primary practice location
1456 136TH Ave
San Leandro, CA 94578-2552
Mailing address
1456 136TH Ave
San Leandro, CA 94578-2552
Phone (510) 618-1501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54704 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318896000000",
"number": "1174806723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1456 136TH AVE",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945782552",
"telephone_number": "510-618-1501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1456 136TH AVE",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945782552",
"telephone_number": "510-618-1504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWOK",
"first_name": "KEVIN",
"middle_name": "V",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-21",
"last_updated": "2011-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "54704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.