Healthcare Provider Details

I. General information

NPI: 1376712844
Provider Name (Legal Business Name): JOSE S. KUA M.D. FACOG INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16415 COLORADO AVE STE 305
PARAMOUNT CA
90723-5053
US

IV. Provider business mailing address

16415 COLORADO AVE STE 305
PARAMOUNT CA
90723-5053
US

V. Phone/Fax

Practice location:
  • Phone: 562-633-5091
  • Fax: 562-633-7857
Mailing address:
  • Phone: 562-633-5091
  • Fax: 562-633-7857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSE SIA KUA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 562-633-5091