Healthcare Provider Details

I. General information

NPI: 1598969339
Provider Name (Legal Business Name): JOE YOSUP KWON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18818 US HIGHWAY 18
APPLE VALLEY CA
92307-2323
US

IV. Provider business mailing address

18818 US HIGHWAY 18
APPLE VALLEY CA
92307-2323
US

V. Phone/Fax

Practice location:
  • Phone: 760-995-8800
  • Fax:
Mailing address:
  • Phone: 760-995-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC203665
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: