Active NPI
Suni Soon Gum Kwon, RN
- Registered Nurse
- Oakland, CA
National Provider Identifier
1851644959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 09400633ORN
- Practice address
- 2501 Harrison St
Oakland, CA 94612-3811 - Phone
- (541) 690-4011
- NPI assigned
- Oct 26, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 09400633ORN | OR | Primary |
Addresses
Primary practice location
2501 Harrison St
Oakland, CA 94612-3811
Mailing address
1645 Taylor Blvd
Lafayette, CA 94549-2117
Phone (541) 690-4011
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09400633ORN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473379200000",
"number": "1851644959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1645 TAYLOR BLVD",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "945492117",
"telephone_number": "541-690-4011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 HARRISON ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946123811",
"telephone_number": "541-690-4011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "SUNI",
"middle_name": "SOON GUM",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-26",
"last_updated": "2016-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "09400633ORN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.