Provider Demographics
NPI:1114912201
Name:Y. JOE KWON, MD
Entity Type:Organization
Organization Name:Y. JOE KWON, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:KWON
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACR
Authorized Official - Phone:760-946-1230
Mailing Address - Street 1:18092 WIKA RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2132
Mailing Address - Country:US
Mailing Address - Phone:760-946-1230
Mailing Address - Fax:760-946-1255
Practice Address - Street 1:18092 WIKA RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2132
Practice Address - Country:US
Practice Address - Phone:760-946-1230
Practice Address - Fax:760-946-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty