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General NPI Number Information
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NPI Number | 1649667072
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Entity Type | Organization
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Legal Business Name | KWOK INTERNAL MEDICINE A MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 895 SIR FRANCIS DRAKE BLVD
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City | SAN ANSELMO
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State | CA
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Zip | 94960-1916
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Country | US
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Telephone | 415-925-3617
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Fax | 415-925-3597
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Provider Business Mailing Address
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Address Line | PO BOX 6671
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City | SANTA ROSA
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State | CA
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Zip | 95406-0671
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Country | US
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Telephone | 415-925-3617
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Fax | 415-925-3597
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL K. KWOK
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Credential | MD
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Telephone | 415-925-3617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | CA
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