Individual provider Active NPI

Peter M Kwon, PHARM.D

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1831544626
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
74120 Issued in CA
Practice address
210 W 7TH St
Los Angeles, CA 90014-1834
Phone
(860) 918-0635
NPI assigned
Apr 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 74120 CA Primary

Addresses

Primary practice location

210 W 7TH St
Los Angeles, CA 90014-1834

Mailing address

11030 Hartsook St Apt 122
North Hollywood, CA 91601-3818
Phone (860) 918-0635

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

LicenseStateTypeSpecialty
74120CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1831544626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11030 HARTSOOK ST APT 122",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916013818",
            "telephone_number": "860-918-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W 7TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900141834",
            "telephone_number": "860-918-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "74120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.