Provider Demographics
NPI:1407852148
Name:KWONG, FRANK K (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:K
Last Name:KWONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:KWONG-FAI
Other - Last Name:KWONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:240 S LA CIENEGA BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3313
Mailing Address - Country:US
Mailing Address - Phone:323-655-8510
Mailing Address - Fax:310-652-0715
Practice Address - Street 1:240 S LA CIENEGA BLVD
Practice Address - Street 2:STE 101
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3313
Practice Address - Country:US
Practice Address - Phone:323-655-8510
Practice Address - Fax:310-652-0715
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGH0830208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
B56853Medicare UPIN
G40830Medicare ID - Type Unspecified
CABJ491ZMedicare PIN