Provider Demographics
NPI:1407909682
Name:KWOK, MONICE J (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICE
Middle Name:J
Last Name:KWOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6504
Mailing Address - Country:US
Mailing Address - Phone:916-679-3693
Mailing Address - Fax:916-679-3699
Practice Address - Street 1:500 UNIVERSITY AVE
Practice Address - Street 2:STE 220
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6504
Practice Address - Country:US
Practice Address - Phone:916-679-3693
Practice Address - Fax:916-679-3699
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42542207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G425420Medicare ID - Type UnspecifiedMEDICAL ID