Individual provider Active NPI

Edwin Kyunghun Kwon, M.D.

  • Family Medicine Physician
  • Orange, CA
National Provider Identifier
1487097846
Registry record updated Jan 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A134063 Issued in CA
Practice address
363 S Main St Ste 110
Orange, CA 92868-3813
Phone
(714) 855-3602
NPI assigned
Apr 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A134063 CA Primary

Addresses

Primary practice location

363 S Main St Ste 110
Orange, CA 92868-3813

Mailing address

363 S Main St Ste 110
Orange, CA 92868-3813
Phone (714) 855-3602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160707002466 CA Practitioner - Family Practice 0648562801 Reassigns benefits to 4 organizations
I20191211000051 OR Practitioner - Family Practice 0648562801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

363 S Main St
Suite 345
Orange, CA 92868-3858
Phone (714) 835-8715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A134063CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CRM Physicians, LLC Family Medicine CurrentSince Dec 1, 2019 Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince Jun 30, 2025 Accepting new patients
Share Our Selves Corporation CurrentSince Jul 27, 2020 Accepting new patients
Share Our Selves Corporation Current Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Jul 23, 2023 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jun 30, 2025 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jul 23, 2023 Accepting new patients
Share Our Selves Corporation CurrentSince Jul 27, 2020 Accepting new patients
Share Our Selves Corporation Current Accepting new patients
Mark W Cheng LLC PastSince Feb 1, 2020 Accepting new patients
UCLA Family Medicine Residency Program Past Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1550 Superior Ave
Costa Mesa, CA 92627
Phone (949) 650-0186

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

363 S Main St
Ste 110
Orange, CA 92868
Phone (714) 855-3602

363 S Main St
Ste 345
Orange, CA 92868
Phone (714) 835-8715

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

11850 SW Allen Blvd
Beaverton, OR 97005
Phone (503) 646-7164

6800 SW 105th Ave
Ste 206
Beaverton, OR 97008

650 SE Oak St
Hillsboro, OR 97123
Phone (503) 648-8588

1675 SW Marlow Ave
Ste 202
Portland, OR 97225

Interoperability endpoints

  • Direct secure messaging: edwin.kwon.p33@direct.monarchhealthcare.nextgenshare.com

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1487097846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 S MAIN ST STE 110",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683813",
            "telephone_number": "714-855-3602",
            "fax_number": "714-822-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 S MAIN ST STE 110",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683813",
            "telephone_number": "714-855-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "EDWIN",
        "middle_name": "KYUNGHUN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2026-01-01",
        "certification_date": "2026-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A134063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.