Provider Demographics
NPI:1396860953
Name:KWAN, WING (PAULINE) LAM (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:WING (PAULINE)
Middle Name:LAM
Last Name:KWAN
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1705
Mailing Address - Country:US
Mailing Address - Phone:213-483-3000
Mailing Address - Fax:213-483-6529
Practice Address - Street 1:1310 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1705
Practice Address - Country:US
Practice Address - Phone:213-483-3000
Practice Address - Fax:213-483-6529
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator