Healthcare Provider Details

I. General information

NPI: 1063592194
Provider Name (Legal Business Name): JEFFREY V KUO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCI MEDICAL CENTER 101 THE CITY DRIVE SOUTH
ORANGE CA
92868
US

IV. Provider business mailing address

UCI DEPT OF RADIATION ONCOLOGY PO BOX 513286
LOS ANGELES CA
90051-3286
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-8978
  • Fax:
Mailing address:
  • Phone: 714-456-6369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG61814
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number000000G61814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: