Healthcare Provider Details

I. General information

NPI: 1477637049
Provider Name (Legal Business Name): TERRY KUO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 12/01/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 S ATLANTIC BLVD STE 101
MONTEREY PARK CA
91754-4772
US

IV. Provider business mailing address

880 S ATLANTIC BLVD STE 101
MONTEREY PARK CA
91754-4772
US

V. Phone/Fax

Practice location:
  • Phone: 626-281-6969
  • Fax: 626-281-2089
Mailing address:
  • Phone: 626-281-6969
  • Fax: 626-281-2089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG077602
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: