Organization Active NPI

Sandra S. Kwak, M.D., Inc.

  • Endocrinology, Diabetes & Metabolism Physician
  • Newport Beach, CA
National Provider Identifier
1528298700
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A88895 Issued in CA
Legal business name
SANDRA S. KWAK, M.D., INC.
Practice address
520 Superior Ave Ste 310
Newport Beach, CA 92663-3667
Phone
(949) 645-8800
Fax
(949) 645-8844
NPI assigned
Jul 22, 2009
Last updated
Aug 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Authorized official

Name
Dr. Sandra Soohyun Kwak, M.D.NPI 1316011364
Title
President
Phone
(949) 645-8800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X A88895 CA Primary

Addresses

Primary practice location

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

Mailing address

PO Box 28884
Belfast, ME 04915-2040
Phone (949) 665-8800

National Provider Directory

National Provider Directory

Locations

520 Superior Ave
Ste 210
Newport Beach, CA 92663
Phone (949) 645-8800

520 Superior Ave
Ste 310
Newport Beach, CA 92663
Phone (949) 645-8800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23147/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1528298700",
    "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": "949-665-8800",
            "fax_number": "949-665-8844"
        },
        {
            "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": {
        "organization_name": "SANDRA S. KWAK, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "KWAK",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "SOOHYUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-645-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A88895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.