Organization
KWANG HE WON HEALTH CENTER
Active
Organization
KWANG HE WON HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONGJA BENA WON MD (CEO/PRESIDENT)
(213) 385-0448
Entity
Organization
Contact information
Practice address
815 S. ARDMORE AVE 1ST FLOOR, LOS ANGELES, CA 90005-2597
(213) 385-0448
(213) 260-8268
Mailing address
815 S. ARDMORE AVE 1ST FLOOR, LOS ANGELES, CA 90005-2597
(213) 385-0448
(213) 260-8268
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A32086
CA MEDICAL BOARD
CA
Enumeration date
02/27/2019
Last updated
03/02/2022
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