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NPI Code Detail

MEDICARE: MICHAEL KWARK

MEDICARE:   MICHAEL  KWARK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RR0500XRheumatology Physician20A25001CA

General Provider Information

NPI Number : 1033798269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL KWARK
Provider Business Mailing Address
First Line : 475 SEAVIEW AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2595 E WASHINGTON BLVD STE 106
Second Line :
City : PASADENA
State : CA
Zip : 91107-1409
Country : US
Telephone Number : 626-794-8133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2021
Last Update Date : 01/23/2026

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Directions to “ MICHAEL KWARK ” Practice Location

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