Kwon, Young Jae

Kwon, Young Jae is an sole proprietor health care provider with primary practice located at 1040 Elm Ave Ste 301 , Long Beach CA 90813-3267. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Kwon, Young Jae can be contacted via phone (562) 435-4777.

Contact Information

Primary practice address
1040 Elm Ave Ste 301 Long Beach CA 90813-3267
Phone: (562) 435-4777
Fax: (562) 435-3947
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A37514 California

Profile Details

NPI number 1225191505
LBN Legal business name Kwon, Young Jae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 18th, 2006
Last updated Jan 30th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225191505 NPPES
California MEDICAID 00A375140

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