Healthcare Provider Details

I. General information

NPI: 1477514701
Provider Name (Legal Business Name): DAVID KUO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2630 SAN GABRIEL BLVD # 200
ROSEMEAD CA
91770-5204
US

IV. Provider business mailing address

2630 SAN GABRIEL BLVD # 200
ROSEMEAD CA
91770-5204
US

V. Phone/Fax

Practice location:
  • Phone: 626-280-9968
  • Fax: 877-400-0565
Mailing address:
  • Phone: 626-280-9968
  • Fax: 877-400-0565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC29998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: