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ETHAN KWONG
NPI 1750184602
Student in an Organized Health Care Education/Training Program in Santa Clara, CA

Active since March 28, 2025PECOS Enrolled
710 LAWRENCE EXPY, SANTA CLARA, CA 95051(408) 851-1000 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 9, 2025, Apr 1, 2025, Mar 28, 2025 (3 updates tracked since 2025).

About Ethan Kwong NPPES

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

ETHAN KWONG (NPI 1750184602) is an individual student in an organized health care education/training program in Santa Clara, California and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750184602
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameETHAN KWONG
Location Address710 LAWRENCE EXPYSanta Clara, CA 95051-5173
Mailing Address839 Shore Breeze DrSacramento, CA 95831-4371
Phone(408) 851-1000
Sole ProprietorNo
Enumeration DateMarch 28, 2025
Last NPPES UpdateApril 22, 20253 updates tracked since enumeration
NPPES CertifiedApril 22, 2025
✔ NPI 1750184602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
710 LAWRENCE EXPY, Santa Clara, CA 95051
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Kwong is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

MRS. SHARLENE JUNIO MADANES N.P.
Nurse Practitioner (Family)
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-3829
ELLEN CHINCHILLI MD
Student in an Organized Health Care Education/Training Program
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-3817
SWARNA L KONERU RD
Dietitian, Registered
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1000
MRS. BRIDGET M. BOUYSSOUNOUSE P.T.
Physical Therapist
710 LAWRENCE EXPY, DEPT. #174
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1466
FLAIR D. GOLDMAN DPM
Podiatrist
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 236-6400
MR. KRISNA P CHAI M.D.
Internal Medicine (Gastroenterology)
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1000
KARISSA TAAN MPT
Physical Therapist
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1492
ANDREA B. HUTCHINSON MD
Obstetrics & Gynecology
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1000

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 Ethan Kwong's NPI number?

The NPI number for Ethan Kwong is 1750184602. It was assigned to this individual provider in the NPPES registry on March 28, 2025.

Where is Ethan Kwong located?

Ethan Kwong practices at 710 Lawrence Expy, Santa Clara, CA 95051. The listed phone number is (408) 851-1000.

What is Ethan Kwong's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ethan Kwong enrolled in Medicare?

Yes. Ethan Kwong is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Kwong was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.