Healthcare Provider Details

I. General information

NPI: 1285070565
Provider Name (Legal Business Name): ESTHER KWON DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 02/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALHAMBRA AVE
MARTINEZ CA
94553-3156
US

IV. Provider business mailing address

450 30TH STREET SUITE 2860
OAKLAND CA
94609
US

V. Phone/Fax

Practice location:
  • Phone: 925-370-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5193
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: