Robert T Kwak (NPI# 1588963243, PAC ID# 7719107432) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1588963243 |
| PAC ID by PECOS | 7719107432 |
| Professional Enrollment ID | I20141001001159 |
| Full Name | Robert T Kwak |
| Organization Legal Name | PERMANENTE MEDICAL GROUP INC |
| Address |
4601 Dale Rd Modesto CA 95356-9718 |
| Phone Number | 2097355000 |
| Gender | M |
| Medical School | UNIVERSITY OF MIAMI SCHOOL OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 8921910225 |
| Number of Group Practice Members | 6775 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050748 | KAISER FOUNDATION HOSPITAL MANTECA |
| Address | Phone | Organization |
|---|---|---|
| 4601 Dale Rd, Modesto, CA 95356-9718 | 2097355000 | PERMANENTE MEDICAL GROUP INC |
| Organization Legal Name | PERMANENTE MEDICAL GROUP INC |
| Physicians | 9623 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard Kailean Mchugh | Otolaryngology | Permanente Medical Group Inc | 7300 Wyndham Dr, Sacramento, CA 95823-4913 |
| Catherine J. Choi | Ophthalmology | Permanente Medical Group Inc | 320 Lennon Ln, Walnut Creek, CA 94598-2419 |
| Justin M Leazenby | Psychologist, Clinical | Permanente Medical Group Inc | 800 Sereno Dr, Vallejo, CA 94589-2411 |
| Crissy A Bankston | Psychologist, Clinical | Permanente Medical Group Inc | 3454 Hillcrest Ave, Antioch, CA 94531-8238 |
| Frank W Lien | Family Medicine | Permanente Medical Group Inc | 1190 Veterans Blvd, Redwood City, CA 94063-2037 |
| Mona Collado Ferrer-kaw | Psychiatry | Permanente Medical Group Inc | 111 Smith Ranch Rd, San Rafael, CA 94903-1939 |
| Matthew J Holland | Psychologist, Clinical | Permanente Medical Group Inc | 1761 Broadway St, Vallejo, CA 94589-2226 |
| Shawn M Youngs | Family Medicine | Permanente Medical Group Inc | 10305 Promenade Pkwy, Elk Grove, CA 95757-9400 |
| Kristin G Leach | Family Medicine | Permanente Medical Group Inc | 9201 Big Horn Blvd, Elk Grove, CA 95758-1240 |
| Valerie M Tiscareno | Qualified Audiologist | Permanente Medical Group Inc | 15 Southgate Ave, Daly City, CA 94015-1413 |
| Street Address |
4601 DALE RD |
| City | MODESTO |
| State | CA |
| Zip | 95356-9718 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Benjamin E Tuy | Orthopedic Surgery | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Mary Anne Apostol Castro | Family Medicine | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Kelly E Quinley | Emergency Medicine | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Khoa D Vu | Internal Medicine | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Dennis Y Wu | Internal Medicine | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Hector Ley Han | Family Medicine | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Benjamin A Thomas | Emergency Medicine | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Maricel M Cubangbang | Otolaryngology | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Garfield Pickell | Family Medicine | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Barbara D Nichols | Emergency Medicine | Permanente Medical Group Inc | 4601 Dale Rd, Modesto, CA 95356-9718 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dean G Early | Chiropractic | 3507 Tully Rd, Suite 300, Modesto, CA 95356-1036 | |
| Ralph W Jeffery | Chiropractic | 200 Auto Ctr Ct, Suite B, Modesto, CA 95356-1573 | |
| Gary W Hall | Chiropractic | 200 Auto Ctr Ct, Modesto, CA 95356-1573 | |
| Nancy E Shoji | Optometry | 4213 Dale Rd, A2, Modesto, CA 95356-8505 | |
| Sheena Reddy Kodavaluru | Internal Medicine | Permanente Medical Group Inc | 3800 Dale Rd, Modesto, CA 95356-8627 |
| Mona Batra | Family Medicine | Permanente Medical Group Inc | 3800 Dale Rd, Modesto, CA 95356-8627 |
| Vijay D Venugopal | Family Medicine | Permanente Medical Group Inc | 3800 Dale Rd, Modesto, CA 95356-8627 |
| Sanjeev K Bansal | Emergency Medicine | Permanente Medical Group Inc | 3800 Dale Rd, Modesto, CA 95356-8627 |
| Corissa L White | Psychologist, Clinical | Permanente Medical Group Inc | 3800 Dale Rd, Modesto, CA 95356-8627 |
| Lalita Mittal | Internal Medicine | Permanente Medical Group Inc | 3800 Dale Rd, Modesto, CA 95356-8627 |
| Find all physicians in zip 95356 | |||
| City | MODESTO |
| Zip Code | 95356 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | MODESTO + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Robert T Kwak.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.