Provider Demographics
NPI:1386985448
Name:MONICE KWOK, M.D., INC.
Entity type:Organization
Organization Name:MONICE KWOK, M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICE
Authorized Official - Middle Name:
Authorized Official - Last Name:KWOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-679-3693
Mailing Address - Street 1:500 UNIVERSITY AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6524
Mailing Address - Country:US
Mailing Address - Phone:916-679-3693
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY AVE STE 270
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6524
Practice Address - Country:US
Practice Address - Phone:916-679-3693
Practice Address - Fax:916-679-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52542207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1407909682Medicare PIN