Healthcare Provider Details

I. General information

NPI: 1114090537
Provider Name (Legal Business Name): ARLENE GWON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 04/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 TRAFALGAR
NEWPORT BEACH CA
92660-6830
US

IV. Provider business mailing address

8 TRAFALGAR
NEWPORT BEACH CA
92660-6830
US

V. Phone/Fax

Practice location:
  • Phone: 949-640-8620
  • Fax: 949-640-6660
Mailing address:
  • Phone: 949-760-6280
  • Fax: 949-640-6660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG22586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: