Healthcare Provider Details

I. General information

NPI: 1548624331
Provider Name (Legal Business Name): DANIEL KUO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18605 GALE AVE STE 222
CITY OF INDUSTRY CA
91748-1344
US

IV. Provider business mailing address

9080 IRVINE CENTER DR
IRVINE CA
92618-4658
US

V. Phone/Fax

Practice location:
  • Phone: 833-476-7377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number271515
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number18290
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number18290
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: