Kwang He Won Health Center

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

KWANG HE WON HEALTH CENTER

Practice address

815 S. Ardmore Ave 1St Floor
Los Angeles, CA 90005-2597

Phone

(213) 385-0448

Fax

(213) 260-8268

NPI assigned

Feb 27, 2019

Last updated

Mar 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bongja Bena Won, MD

Title

Ceo/President

Phone

(213) 385-0448

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699232454. Details of each certification follow.

• CCN 551014 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 551014

Legal name

KWANG HE WON HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 21, 2023

Last certification

Mar 21, 2023

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

in CA

Enrollment address

815 S Ardmore Ave
FL 1
Los Angeles, CA 90005-2597

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FDJDCD

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Hany S Malek, DC

  • Chiropractor
  • Los Angeles, CA
  • NPI 1548361090

  Corporate Officer, W-2 Managing Employee

  CMS ownership

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Kwang He Won Health Center

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1417828823
  NPPES parent name

Practitioners 9

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.

• Richard Bardowell, M.D.

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
  • NPI 1790796753
  Medicare reassignment NPD
• Leslie A. Langley, DNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • North Hollywood, CA
  • NPI 1255779120
  Medicare reassignment NPD
• Jae W Lee, M.D.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1639265143
  Medicare reassignment NPD
• Ji Youn Lee

  • Primary Care Nurse Practitioner
  • Los Angeles, CA
  • NPI 1912435553
  Medicare reassignment NPD
• Daesoon Leem, MD

  • Sports Medicine (Family Medicine) Physician
  • Los Angeles, CA
  • NPI 1902289226

  General Practice

  Medicare reassignment NPD
• Helena Songhee Park, NP

  • Family Nurse Practitioner
  • Corona, CA
  • NPI 1093061970
  Medicare reassignment NPD
• Young Seok Suh, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1396708251
  Medicare reassignment NPD
• Brandon S Oh, AC

  • Acupuncturist
  • Los Angeles, CA
  • NPI 1730327339
  NPD
• Young Kim, DDS

  • General Practice Dentistry
  • Anaheim, CA
  • NPI 1750479218
  NPD (past)

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1699232454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 S. ARDMORE AVE 1ST FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052597",
            "telephone_number": "213-385-0448",
            "fax_number": "213-260-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S. ARDMORE AVE 1ST FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052597",
            "telephone_number": "213-385-0448",
            "fax_number": "213-260-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWANG HE WON HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-27",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "WON",
        "authorized_official_first_name": "BONGJA",
        "authorized_official_middle_name": "BENA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "213-385-0448",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL BOARD",
            "identifier": "A32086",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Arlene Kwan, ACSW
• William Warren Kwan, MD
• Wing (Pauline) Lam Kwan, CASE MANAGER
• Cesar Ricardo Kwandiaz
• Kwang He Won Health Center
• Kwang S. Kim DDS, Inc
• Isidore K.W. Kwaw, MD
• Lindajani Kwee, DDS
• Richard Kwee
• Cheul H Kwen, L.AC.

• Community Health Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Community Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.