Healthcare Provider Details

I. General information

NPI: 1922425297
Provider Name (Legal Business Name): DAVID H KWON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9898 GENESEE AVE
LA JOLLA CA
92037-1205
US

IV. Provider business mailing address

748 S MEADOWS PKWY STE A9
RENO NV
89521-4841
US

V. Phone/Fax

Practice location:
  • Phone: 858-824-5404
  • Fax:
Mailing address:
  • Phone: 775-322-4550
  • Fax: 775-322-4776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036155741
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number17470
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA154517
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number17470
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number17470
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: