Healthcare Provider Details

I. General information

NPI: 1003011016
Provider Name (Legal Business Name): PATRICK KUO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1669 S MAIN ST
MILPITAS CA
95035-6200
US

IV. Provider business mailing address

1669 S MAIN ST
MILPITAS CA
95035-6200
US

V. Phone/Fax

Practice location:
  • Phone: 408-942-7479
  • Fax:
Mailing address:
  • Phone: 408-942-7479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number11526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: