Provider Demographics
NPI:1205097474
Name:KWAN, MATTHEW DAVID (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DAVID
Last Name:KWAN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:100 UCLA MEDICAL PLZ STE 255
Mailing Address - Street 2:UCLA DEPT OF ORTHOPAEDIC SURGERY / HAND & MICROSURGERY
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6913
Mailing Address - Country:US
Mailing Address - Phone:310-825-6557
Mailing Address - Fax:310-825-1311
Practice Address - Street 1:100 UCLA MEDICAL PLZ STE 255
Practice Address - Street 2:UCLA DEPT OF ORTHOPAEDIC SURGERY / HAND & MICROSURGERY
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-6913
Practice Address - Country:US
Practice Address - Phone:310-825-6557
Practice Address - Fax:310-825-1311
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2021-12-20
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Provider Licenses
StateLicense IDTaxonomies
CAA104349208600000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery