Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | POD.0000855 | CO |
Y | 222Z00000X | Podiatrist | POD.0000855 | CO |
NPI | 1003225160 |
---|---|
Provider Name | Dr. Alfred Kwon |
First Address | Littleton, CO 80127-6423 |
Second Address | Littleton, CO 80127-6423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2014 |
Last Update Date | 22/05/2020 |