Active NPI
Kenneth Boon-Yun Kwan, PHARMD
- Pharmacist
- Antioch, CA
National Provider Identifier
1619279924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 60748
- Practice address
- 4501 Sand Creek Rd
Antioch, CA 94531-8687 - Phone
- (925) 813-7280
- NPI assigned
- Nov 19, 2010
- Last updated
- Nov 19, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 60748 | CA | Primary |
| Pharmacist | 183500000X | PS44540 | FL |
Addresses
Primary practice location
4501 Sand Creek Rd
Antioch, CA 94531-8687
Mailing address
440 Cesano CT Apt 214
Palo Alto, CA 94306-4453
Phone (650) 917-1095
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS44540 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290124800000",
"number": "1619279924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 CESANO CT APT 214",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943064453",
"telephone_number": "650-917-1095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4501 SAND CREEK RD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945318687",
"telephone_number": "925-813-7280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAN",
"first_name": "KENNETH",
"middle_name": "BOON-YUN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-19",
"last_updated": "2010-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "60748",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS44540",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.