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Individual
JACLYN KWAN
Active
Individual
JACLYN KWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA51734
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1118385
NCCPA LICENSE NUMBER
CA
01
—
PA51734
CA STATE LICENSE NUMBER
CA
Enumeration date
07/16/2014
Last updated
02/18/2016
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