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General NPI Number Information
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NPI Number | 1740528082
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Entity Type | Individual
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Provider Name | HAU SHAN KWONG
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Gender | Female
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 509 N CORDOVA ST
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City | ALHAMBRA
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State | CA
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Zip | 91801-2714
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Country | US
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Telephone | 626-320-6023
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Fax |
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Provider Business Mailing Address
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Address Line | 1740 NEW AVE SUITE 101
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3735
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Country | US
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Telephone | 626-320-6023
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA19111
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 584306
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License Number State | CA
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