Healthcare Provider Details

I. General information

NPI: 1073765400
Provider Name (Legal Business Name): STEVEN KWON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NE NEFF RD
BEND OR
97701-6015
US

IV. Provider business mailing address

1590 ROSECRANS AVE STE D314
MANHATTAN BEACH CA
90266-3727
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-6892
  • Fax: 541-706-6813
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA110041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: