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General NPI Number Information
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NPI Number | 1992982292
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Entity Type | Organization
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Legal Business Name | HENRY KAW MD INC
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 321 N POMONA AVE SUITE B
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City | FULLERTON
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State | CA
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Zip | 92832-1927
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Country | US
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Telephone | 714-462-8383
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Fax | 714-462-8384
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Provider Business Mailing Address
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Address Line | 321 N POMONA AVE SUITE B
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City | FULLERTON
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State | CA
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Zip | 92832-1927
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Country | US
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Telephone | 714-462-8383
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Fax | 714-462-8384
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Authorized Official
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Title or Position | CEO
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Name | DR. HENRY R KAW JR.
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Credential | M.D.
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Telephone | 714-747-7476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A95068
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License Number State | CA
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