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General NPI Number Information
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NPI Number | 1568628642
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Entity Type | Organization
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Legal Business Name | OCEAN RADIATION ONCOLOGY MEDICAL ASSOC
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 3951 KATELLA AVE SUITE 102
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3303
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Country | US
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Telephone | 562-799-3198
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Fax | 562-799-3509
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Provider Business Mailing Address
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Address Line | 3951 KATELLA AVE SUITE 102
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3303
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Country | US
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Telephone | 562-799-3198
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Fax | 562-799-3509
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT S KWON
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Credential | M.D.
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Telephone | 562-799-3198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | FNP37709
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License Number State | CA
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