Provider Demographics
NPI:1649492174
Name:VICTOR KWOK MD LLC
Entity type:Organization
Organization Name:VICTOR KWOK MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALVADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-523-9363
Mailing Address - Street 1:820 MILILANI STREET
Mailing Address - Street 2:SUITE 702A
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-523-9363
Mailing Address - Fax:808-523-9418
Practice Address - Street 1:2228 LILIHA STREET
Practice Address - Street 2:MOD 105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-538-1929
Practice Address - Fax:808-538-1920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-12488207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH100975Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER