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NPI Code Detail

MEDICARE: SEAN HYUNCHANG KWAK

MEDICARE: SEAN HYUNCHANG KWAK
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1568264711
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN HYUNCHANG KWAK
Provider Business Mailing Address
First Line : 9500 EUCLID AVE # JJ24
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2200
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE # JJ24
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2025
Last Update Date : 01/19/2026

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Directions to “ SEAN HYUNCHANG KWAK ” Practice Location

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