Individual
GRACE EUN KWON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
17452 IRVINE BLVD STE 213, TUSTIN, CA 92780-3031
(714) 371-6977
(800) 836-2401
Mailing address
10212 COWAN HEIGHTS DR, SANTA ANA, CA 92705-1566
(310) 753-5805
(800) 896-2401
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20A12013
CA
2084P0800X
Psychiatry Physician
54077
CT
2084P0802X
Addiction Psychiatry Physician
20A12013
CA
2084P0802X
Addiction Psychiatry Physician
54077
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008059045
KWON MEDICAID
CT
01
—
D400248447
KWON MEDICARE
CT
Enumeration date
03/23/2011
Last updated
05/07/2026
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