Provider Demographics
NPI:1679339402
Name:KWAN, SARI
Entity Type:Individual
Prefix:
First Name:SARI
Middle Name:
Last Name:KWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11927 ELLIOTT AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-3740
Mailing Address - Country:US
Mailing Address - Phone:626-350-5304
Mailing Address - Fax:626-350-0756
Practice Address - Street 1:11927 ELLIOTT AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-3740
Practice Address - Country:US
Practice Address - Phone:626-350-5304
Practice Address - Fax:626-350-0756
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program