Healthcare Provider Details

I. General information

NPI: 1952793812
Provider Name (Legal Business Name): KUO CHIROPRACTIC PAIN CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 S GARFIELD AVE SUITE 222
ALHAMBRA CA
91801-3886
US

IV. Provider business mailing address

368 VALLEY CIR
MONROVIA CA
91016-5086
US

V. Phone/Fax

Practice location:
  • Phone: 626-905-2644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberDC29998
License Number StateCA

VIII. Authorized Official

Name: DR. DAVID KUO
Title or Position: PRESIDENT
Credential: D.C.
Phone: 626-905-2644