Healthcare Provider Details

I. General information

NPI: 1881941250
Provider Name (Legal Business Name): HOI YAN KWONG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2012
Last Update Date: 07/07/2023
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SAN PABLO ST
LOS ANGELES CA
90033-5313
US

IV. Provider business mailing address

PO BOX 31309
LOS ANGELES CA
90031-0309
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-8500
  • Fax:
Mailing address:
  • Phone: 323-442-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number22136
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number22136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: