Seungjae Kwon

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

303592 Issued in CA

Practice address

3921 Cochran St
Simi Valley, CA 93063-2364

Phone

(805) 327-1100

NPI assigned

Feb 6, 2023

Last updated

Feb 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1780380170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 EVERGREEN AVE APT A3",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352053",
            "telephone_number": "714-823-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 COCHRAN ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632364",
            "telephone_number": "805-327-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Duesenberg Dr",
            "address_purpose": "LOCATION",
            "city": "Westlake Village",
            "state": "CA",
            "postal_code": "913623409",
            "country_code": "US",
            "telephone_number": "805-413-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "SEUNGJAE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William H Kwan, DPM
• Kwanho Chong, M.D., a Medical Corporation
• Jenna Rhian Kwiatkowski, RN, BSN
• Allan Waylee Kwok, DPT
• Virat Kwok, PHARMD
• L&T Non Emergency Transportation
• William Lainfiesta
• Michael Lawrence Lajeunesse Jr., CADC-1
• Isaac Robert Lake
• Lakeside Medical Associates, a Medical Group, Inc. (Lakeside Community Healthcare Medical Group)

• Physical Therapist in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.