| Sandra S. Kwak, M.D., Inc. | |
|
520 Superior Ave Ste 310 Newport Beach CA 92663-3667 | |
| (949) 645-8800 | |
| (949) 645-8844 |
| Full Name | Sandra S. Kwak, M.D., Inc. |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 520 Superior Ave Ste 310, Newport Beach, California |
| Authorized Official Name and Position | Sandra Soohyun Kwak (PRESIDENT) |
| Authorized Official Contact | 9496458800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra S. Kwak, M.D., Inc. Po Box 28884 Belfast ME 04915-2040 Ph: (949) 665-8800 | Sandra S. Kwak, M.D., Inc. 520 Superior Ave Ste 310 Newport Beach CA 92663-3667 Ph: (949) 645-8800 |
| NPI Number | 1528298700 |
|---|---|
| Provider Enumeration Date | 07/22/2009 |
| Last Update Date | 08/10/2021 |
| Certification Date | 08/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528298700 | NPI | - | NPPES |
| 1316011364 | Other | CA | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | A88895 (California) | Primary |
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