YONG KU KWON PA NPI 1033204631

NPI Information

  • NPI: 1033204631
  • Provider Name: YONG KU KWON, PA
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5677 BUFORD HWY NE STE 210
    DORAVILLE, GA
    ZIP 30340
  • Phone: (678) 547-1045

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NPI Details

Yong Ku Kwon, PA is a medical physician assistant in Doraville, GA. Yong Ku Kwon, PA NPI is 1033204631. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5677 BUFORD HWY NE STE 210
DORAVILLE, GA
ZIP 30340-200
Phone: (678) 547-1045
Fax: (678) 547-1048

The NPI 1033204631 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/3/2006 and was last updated on 1/11/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical004834GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1511I970362MEDICARE PIN
2379290255BMEDICAIDGEORGIA
3379290255AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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