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NPI Code Detail

MEDICARE: CHAELIN KWON PA

MEDICARE: CHAELIN KWON PA
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 AssistantPA3419NV

General Provider Information

NPI Number : 1508718487
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAELIN KWON PA
Provider Business Mailing Address
First Line : 871 CORONADO CENTER DR
Second Line :
City : HENDERSON
State : NV
Zip : 89052-3977
Country : US
Telephone Number : 702-566-2400
Fax Number :
Provider Business Practice Location Address
First Line : 871 CORONADO CENTER DR
Second Line :
City : HENDERSON
State : NV
Zip : 89052-3977
Country : US
Telephone Number : 702-566-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/12/2026

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Directions to “ CHAELIN KWON PA” Practice Location

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