Healthcare Provider Details

I. General information

NPI: 1053866194
Provider Name (Legal Business Name): RONALD KUO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ZAW M LATT DDS

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10354 GARVEY AVE STE B
EL MONTE CA
91733-2133
US

IV. Provider business mailing address

10354 GARVEY AVE STE B
EL MONTE CA
91733-2133
US

V. Phone/Fax

Practice location:
  • Phone: 626-350-8366
  • Fax:
Mailing address:
  • Phone: 626-679-2460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number32261
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number100914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: