Healthcare Provider Details

I. General information

NPI: 1619084159
Provider Name (Legal Business Name): DAN K K KWOK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAN K KWAK

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 05/22/2025
Certification Date: 04/02/2024
Deactivation Date: 03/18/2025
Reactivation Date: 05/22/2025

III. Provider practice location address

1 JARRETT WHITE RD STE 700
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

IV. Provider business mailing address

684 WAIANAE AVE
SCHOFIELD BARRACKS HI
96857
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-6661
  • Fax: 808-433-1551
Mailing address:
  • Phone: 808-433-8854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDOS-1191
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: