| Doctor Name: | SOON KWAK |
| NPI Number: | 1235547662 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | A29868 |
| Business Practice Address: | 806 Teakwood Rd Los Angeles, CA - 900491330 |
| Business Phone Number: | 3104768212 |
| Business Fax Number: | |
| Mailing Address: | 122 West St, Unit 4i BROOKLYN |
| State: | NY |
| Postal Code: | 112221970 |
| Phone Number: | 9175881505 |
| Fax Number: | |
| NPI Enumeration Date: | 07/29/2014 |
| NPI Last Update Date: | 07/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A29868 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |