Individual
ISIDORE K.W. KWAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9201 SUNSET BLVD, 705, LOS ANGELES, CA 90069-3708
(310) 271-2744
(310) 276-1732
Mailing address
PO BOX 5280, HUNTINGTON BEACH, CA 92615-5280
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G66583
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G665830
BLUE SHIELD
CA
05
—
00G665830
—
CA
01
—
930114393
RAILROAD MEDICARE
CA
Enumeration date
07/15/2006
Last updated
11/29/2012
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