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General NPI Number Information
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NPI Number | 1780805424
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Entity Type | Organization
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Legal Business Name | LOUIS M. KWONG, M.D., A MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 9675 BRIGHTON WAY SUITE 410
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5100
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Country | US
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Telephone | 310-399-5480
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Fax | 310-399-5490
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Provider Business Mailing Address
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Address Line | 9663 SANTA MONICA BLVD SUITE 1230
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4303
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Country | US
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Telephone | 310-399-5480
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Fax | 310-399-5490
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. LOUIS MATTHEW KWONG
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Credential | M.D.
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Telephone | 310-399-5480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | G55440
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License Number State | CA
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