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General NPI Number Information
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NPI Number | 1285145995
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Entity Type | Individual
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Provider Name | JOSH KWAN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 11/29/2017
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Provider Practice Location Address
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Address Line | 14807 CONDON AVE UNIT 105
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City | LAWNDALE
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State | CA
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Zip | 90260-1210
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Country | US
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Telephone | 310-985-8772
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Fax |
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Provider Business Mailing Address
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Address Line | 9808 VENICE BLVD STE 707
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City | CULVER CITY
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State | CA
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Zip | 90232-6802
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Country | US
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Telephone | 310-237-0023
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Fax | 310-237-0026
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95007660
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License Number State | CA
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