Organization
LOUIS M. KWONG, M.D., A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS MATTHEW KWONG M.D. (DOCTOR)
(310) 399-5480
Entity
Organization
Contact information
Practice address
9675 BRIGHTON WAY, SUITE 410, BEVERLY HILLS, CA 90210-5100
(310) 399-5480
(310) 399-5490
Mailing address
9663 SANTA MONICA BLVD, SUITE 1230, BEVERLY HILLS, CA 90210-4303
(310) 399-5480
(310) 399-5490
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
G55440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200348500
DOL-OWCP
—
01
—
W21411
MEDICARE PTAN
—
Enumeration date
05/01/2007
Last updated
09/29/2014
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