Healthcare Provider Details

I. General information

NPI: 1396122990
Provider Name (Legal Business Name): ARLEN KWONG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2015
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3133 N MILLBROOK AVE
FRESNO CA
93703-1425
US

IV. Provider business mailing address

155 N FRESNO ST
FRESNO CA
93701-2302
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-8918
  • Fax: 559-600-7701
Mailing address:
  • Phone: 559-449-6580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A15263
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: