Provider Demographics
NPI:1740200575
Name:KWAN, ABEL S (LAC)
Entity Type:Individual
Prefix:DR
First Name:ABEL
Middle Name:S
Last Name:KWAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18740 VENTURA BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3366
Mailing Address - Country:US
Mailing Address - Phone:818-708-1698
Mailing Address - Fax:866-423-6093
Practice Address - Street 1:18740 VENTURA BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3366
Practice Address - Country:US
Practice Address - Phone:818-708-1698
Practice Address - Fax:866-423-6093
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3369171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist