Healthcare Provider Details

I. General information

NPI: 1679651723
Provider Name (Legal Business Name): ROBERT KWOK, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 06/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 POLLARD RD STE 108
LOS GATOS CA
95032-1435
US

IV. Provider business mailing address

825 POLLARD RD STE 108
LOS GATOS CA
95032-1435
US

V. Phone/Fax

Practice location:
  • Phone: 408-370-3774
  • Fax: 408-370-7011
Mailing address:
  • Phone: 408-370-3774
  • Fax: 408-370-7011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT KWOK
Title or Position: PRESIDENT
Credential: MD
Phone: 408-370-3774