Healthcare Provider Details

I. General information

NPI: 1548338189
Provider Name (Legal Business Name): NORMAN KUO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5471 LA PALMA AVE SUITE 105
LA PALMA CA
90623-1745
US

IV. Provider business mailing address

5471 LA PALMA AVE
LA PALMA CA
90623-1745
US

V. Phone/Fax

Practice location:
  • Phone: 714-521-0239
  • Fax: 714-521-0218
Mailing address:
  • Phone: 714-521-0239
  • Fax: 714-521-0218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA37079
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: