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NPI Code Detail

MEDICARE: ASHLEY KWON PA-C

MEDICARE: ASHLEY KWON PA-C
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
1363A00000XPhysician Assistant67433CA

General Provider Information

NPI Number : 1376400143
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY KWON PA-C
Provider Business Mailing Address
First Line : 4650 W SUNSET BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-6062
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4650 W SUNSET BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-6062
Country : US
Telephone Number : 323-361-4586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ ASHLEY KWON PA-C” Practice Location

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