Provider Demographics
NPI:1710074026
Name:QUON, HEW WAH (MD)
Entity Type:Individual
Prefix:DR
First Name:HEW
Middle Name:WAH
Last Name:QUON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 N HILL ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2321
Mailing Address - Country:US
Mailing Address - Phone:213-680-0456
Mailing Address - Fax:
Practice Address - Street 1:808 N HILL ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2321
Practice Address - Country:US
Practice Address - Phone:213-680-0456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34428207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G344280Medicaid
CA00G344280Medicaid
CAG34428Medicare ID - Type Unspecified