Provider Demographics
NPI:1336101500
Name:KWAN, CHUK W (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUK
Middle Name:W
Last Name:KWAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:929 CLAY ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-1556
Mailing Address - Country:US
Mailing Address - Phone:415-398-5926
Mailing Address - Fax:415-398-6956
Practice Address - Street 1:929 CLAY ST
Practice Address - Street 2:SUITE 600
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-1556
Practice Address - Country:US
Practice Address - Phone:415-398-5926
Practice Address - Fax:415-398-6956
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG32238207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G322380Medicaid
00G322380Medicare ID - Type Unspecified
CA00G322380Medicaid