Active NPI
William H Kwan, DPM
- Podiatrist
- Simi Valley, CA
National Provider Identifier
1710097191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E2917
- Practice address
- 125 Parrot LN
Simi Valley, CA 93065-3151 - Phone
- (805) 584-3668
- Fax
- (805) 584-0016
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E2917 | CA | Primary |
Addresses
Primary practice location
125 Parrot LN
Simi Valley, CA 93065-3151
Mailing address
125 Parrot LN
Simi Valley, CA 93065-3151
Phone (805) 584-3668
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000E29170 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E2917 | CA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366502400000",
"number": "1710097191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 PARROT LN",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930653151",
"telephone_number": "805-584-3668",
"fax_number": "805-584-0016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 PARROT LN",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930653151",
"telephone_number": "805-584-3668",
"fax_number": "805-584-0016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAN",
"first_name": "WILLIAM",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2013-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E2917",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000E29170",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.