Healthcare Provider Details

I. General information

NPI: 1922178581
Provider Name (Legal Business Name): ANGELICA KUO D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 S GARFIELD AVE SUITE 208
ALHAMBRA CA
91801-3892
US

IV. Provider business mailing address

330 S GARFIELD AVE SUITE 208
ALHAMBRA CA
91801-3892
US

V. Phone/Fax

Practice location:
  • Phone: 626-869-9468
  • Fax: 626-282-0932
Mailing address:
  • Phone: 626-869-9468
  • Fax: 626-282-0932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC29503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: