Sandra Soohyun Kwak, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

A88895 Issued in CA

Practice address

520 Superior Ave Ste 310
Newport Beach, CA 92663-3667

Phone

(949) 645-8800

Fax

(949) 645-8844

NPI assigned

Nov 20, 2006

Last updated

Aug 10, 2021By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sandra S. Kwak, M.D., Inc.

  • Endocrinology, Diabetes & Metabolism Physician
  • Newport Beach, CA
  • NPI 1528298700
  Authorized official Same address or phone
• Kris V Iyer MD Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Newport Beach, CA
  • NPI 1730207564
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1316011364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28884",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049152040",
            "telephone_number": "949-645-8800",
            "fax_number": "949-645-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE STE 310",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633667",
            "telephone_number": "949-645-8800",
            "fax_number": "949-645-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "SANDRA",
        "middle_name": "SOOHYUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A88895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilan Kuperman, M.D.
• Max Christopher Kupferman, PA-C
• Katerina Kurteeva, MD
• Daria Joanna Kusior, PHARMD
• Isabelle Kuykendall
• Amy Kwan, MD
• Jessica J Kwon, PHARM.D.
• Rachel Kwon, PSYD
• Sarah K Kwon
• Kymry Fowler, Inc.

• Endocrinology, Diabetes & Metabolism Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.