Organization
SANDRA S. KWAK, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA SOOHYUN KWAK M.D. (PRESIDENT)
(949) 645-8800
Entity
Organization
Contact information
Practice address
520 SUPERIOR AVE STE 310, NEWPORT BEACH, CA 92663-3667
(949) 645-8800
(949) 645-8844
Mailing address
PO BOX 28884, BELFAST, ME 04915-2040
(949) 665-8800
(949) 665-8844
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A88895
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316011364
INDIVIDUAL NPI NUMBER
CA
Enumeration date
07/22/2009
Last updated
08/10/2021
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