MIMMIE KWONG (NPI# 1417392663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417392663 |
| Entity Type | Individual |
| Full Name | MIMMIE KWONG |
| Credential | M.D. |
| Practice Address |
4860 Y St Ste 2100 Sacramento CA 95817-2307 |
| Mailing Address |
2335 Stockton Blvd., 6th Floor North Addition Office Building Sacramento CA 95817-1418 |
| Practice Telephone | 9167343800 |
| Practice Fax Number | 9167343801 |
| Mailing Telephone | 9167342028 |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2019-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
A140004 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
4860 Y ST STE 2100 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95817-2307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730478082 | Steven Maximus | Surgery | 4860 Y St Ste 2100, Sacramento, CA 95817-2309 | 2011-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346855103 | Quintin Kuse | Student in an Organized Health Care Education/Training Program | 4610 X Street, Sacramento, Sacramento, CA 95817 | 2020-09-09 |
| 1285259283 | Uc Davis Health | Dietitian, Registered | 2315 Stockton Blvd Sesp 0160, Sacramento, CA 95817 | 2020-06-15 |
| 1942840558 | Michael Marchand-gareau | Ophthalmology | Michael Marchand - Uc Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817 | 2020-01-11 |
| 1467010728 | Jiunn Liang Jonathan Yap | Student in an Organized Health Care Education/Training Program | 4860 Y Str, Ste. 2820, Sacramento, CA 95817 | 2019-06-03 |
| 1083176614 | Kevin Lee | Student in an Organized Health Care Education/Training Program | 2315 Stockton Blvd, Op512, Sacramento, CA 95817 | 2019-04-02 |
| 1508326703 | Ritika Johal | Student in an Organized Health Care Education/Training Program | 4150 V Street, Pssb 1200, Sacramento, CA 95817 | 2019-03-22 |
| 1811468838 | Paige Palsgaard | Behavior Technician | 6730 4th Ave Apt 1731d, Sacramento, CA 95817 | 2018-12-17 |
| 1922503408 | Marie Rossi | Student in an Organized Health Care Education/Training Program | 4150 V Street #1100, Sacramento, CA 95817 | 2018-03-27 |
| 1639673791 | Sean Lam | Student in an Organized Health Care Education/Training Program | 4150 V Street #1200, Sacramento, CA 95817 | 2018-03-22 |
| 1124555388 | Tatyana Polyak | Surgery | 2335 Stockton Blvd., Naob 6th Floor, Sacramento, CA 95817 | 2017-05-18 |
| Find all providers in zip 95817 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619389939 | Andrew Wishy | Surgery | 5749 Bridgecross Dr, Sacramento, CA 95835-1902 | 2014-05-21 |
| 1730478082 | Steven Maximus | Surgery | 4860 Y St Ste 2100, Sacramento, CA 95817-2309 | 2011-04-06 |
| 1841218690 | Richard Edward Ward | Surgery | 3941 J St 362, Sacramento, CA 95819-3633 | 2006-07-18 |
| 1295753036 | Charles Thomas Brownridge | Surgery | 2800 L St Ste 260, Sacramento, CA 95816-5616 | 2006-07-18 |
| 1508841537 | Daniel Peter Link Jr. | Surgery | 500 University Ave Ste 250, Sacramento, CA 95825-6525 | 2005-12-13 |
| 1417512195 | Kathryn Lambeth Dilosa | Surgery | 2315 Stockton Blvd, Sacramento, CA 95817-2201 | 2019-05-07 |
| 1730587379 | Eric Kuo | Surgery | 2725 Capitol Ave Dept 402, Sacramento, CA 95816-6032 | 2014-12-14 |
| 1174949085 | Josefina Anita Dominguez | Surgery | 2725 Capitol Ave Dept 402, Sacramento, CA 95816-6032 | 2014-03-16 |
| 1982946687 | Ronald G. Jan, M.d., Inc | Surgery | 5025 J St, Suite 312, Sacramento, CA 95819 | 2013-03-20 |
| 1114291366 | Ali Tajlil Md Inc | Surgery | 3941 J Street, Suite 370, Sacramento, CA 95819-3633 | 2012-03-06 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95817 |
Please comment or provide details below to improve the information on MIMMIE KWONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.