Healthcare Provider Details

I. General information

NPI: 1407852148
Provider Name (Legal Business Name): FRANK K KWONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FRANK KWONG-FAI KWONG MD

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 S LA CIENEGA BLVD STE 101
BEVERLY HILLS CA
90211-3313
US

IV. Provider business mailing address

240 S LA CIENEGA BLVD STE 101
BEVERLY HILLS CA
90211-3313
US

V. Phone/Fax

Practice location:
  • Phone: 323-655-8510
  • Fax: 310-652-0715
Mailing address:
  • Phone: 323-655-8510
  • Fax: 310-652-0715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberGH0830
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: