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General NPI Number Information
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NPI Number | 1750336095
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Entity Type | Individual
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Provider Name | HOSUN KWON MFC
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 10/13/2007
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Provider Practice Location Address
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Address Line | 5900 SEPULVEDA BLVD STE 425
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City | VAN NUYS
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State | CA
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Zip | 91411-2526
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Country | US
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Telephone | 818-267-1100
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Fax | 818-267-1199
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Provider Business Mailing Address
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Address Line | 520 SO. LAFAYETTE PARK PLACE 3RD FLOOR
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City | LA
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State | CA
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Zip | 90057
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Country | US
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Telephone | 213-252-2100
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Fax | 213-383-3146
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC40611
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License Number State | CA
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