Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bum Won Kwak, PA

Individual provider Physician Assistant · NPI 1093505257

Bum Won Kwak, PA is a Physician Assistant in Los Angeles, California. Qualified in 2024, 2 years ago. Registered with an NPI since 2025.

Years since qualifying
2
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

966 S Westmoreland Ave Apt 1
Los Angeles, CA 90006-5611
Phone: (315) 804-1825
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1093505257
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 10, 2025
Last updated in NPPESMay 10, 2025
Certification dateMay 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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