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K. KWANG SOO, M.D., S.C.
NPI 1336296722
Clinic/Center - Adult Mental Health in Milwaukee, WI

Active since January 05, 2007
2691 N LAKE DR, MILWAUKEE, WI 53211(414) 228-8300(414) 228-6303 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About K. Kwang Soo, M.d., S.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

K. KWANG SOO, M.D., S.C. (NPI 1336296722) is a healthcare organization registered as an adult mental health in Milwaukee, Wisconsin and active in the NPI registry since January 2007. The organization lists Kam Kwang Soo, President, as its authorized official.

NPPES Registry Identity

NPI1336296722
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameK. KWANG SOO, M.D., S.C.
Location Address2691 N LAKE DRMilwaukee, WI 53211-3838
Mailing AddressPo Box 170526Milwaukee, WI 53217-8046 · (414) 228-8300 · Fax (414) 228-6303
Phone(414) 228-8300
Fax(414) 228-6303
Organization SubpartNo
Authorized OfficialKam Kwang SooPresident · (414) 964-6077
Enumeration DateJanuary 5, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1336296722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
License✔ Licensed in WI · 19331
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
2691 N LAKE DR, Milwaukee, WI 53211
Open in Google Maps ↗

Other Identifiers 1

Medicaid301 529 00WI

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVOLVE PHYSICAL THERAPY AND SPORTS MEDICINE LLC
Clinic/Center (Physical Therapy)
2691 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 840-9409

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is K. Kwang Soo, M.D., S.C.'s NPI number?

The NPI number for K. Kwang Soo, M.D., S.C. is 1336296722. It was assigned to this organization in the NPPES registry on January 5, 2007.

Where is K. Kwang Soo, M.D., S.C. located?

K. Kwang Soo, M.D., S.C. is located at 2691 N Lake Dr, Milwaukee, WI 53211. The listed phone number is (414) 228-8300.

What is K. Kwang Soo, M.D., S.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for K. Kwang Soo, M.D., S.C. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.