Individual
WALTER KWASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 SOUTHGATE AVE, DALY CITY, CA 94015-2259
(650) 991-6780
Mailing address
1580 LAUREL ST, SAN CARLOS, CA 94070-5157
(650) 394-4492
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
016674
CT
2086S0129X
Vascular Surgery Physician
35851
MA
2086S0129X
Vascular Surgery Physician
Primary
89436
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001166743
—
CT
05
—
2169801
—
MA
Enumeration date
11/15/2005
Last updated
03/17/2018
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