Provider Demographics
NPI:1770859456
Name:KWAN, YUET FONG SZETO
Entity Type:Individual
Prefix:
First Name:YUET FONG
Middle Name:SZETO
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:PO BOX 321
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95015-0321
Mailing Address - Country:US
Mailing Address - Phone:510-435-6978
Mailing Address - Fax:
Practice Address - Street 1:2916 ELMWOOD CT
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2326
Practice Address - Country:US
Practice Address - Phone:510-843-1936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program