Organization
GRACE KWON CORPORATION
Active
Other names
Grace Kwon Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE KWON DO (PRESIDENT)
(310) 753-5805
Entity
Organization
Contact information
Practice address
17452 IRVINE BLVD STE 213, TUSTIN, CA 92780-3031
(657) 371-6977
Mailing address
17452 IRVINE BLVD STE 213, TUSTIN, CA 92780-3031
(657) 346-2080
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
106S00000X
Behavior Technician
—
—
164X00000X
Licensed Vocational Nurse
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/20/2019
Last updated
02/11/2026
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