Provider Demographics
NPI:1508815242
Name:KWAN, SCOTT (DPT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:KWAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E MAIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4150
Mailing Address - Country:US
Mailing Address - Phone:626-243-3829
Mailing Address - Fax:626-451-9937
Practice Address - Street 1:1300 E MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4150
Practice Address - Country:US
Practice Address - Phone:626-451-9903
Practice Address - Fax:626-451-9937
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist