Healthcare Provider Details

I. General information

NPI: 1982680716
Provider Name (Legal Business Name): MICHAEL C KUO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST #3100
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

1849 41ST ST
SACRAMENTO CA
95819-4015
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-5195
  • Fax: 916-734-6548
Mailing address:
  • Phone:
  • Fax: 916-734-6548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License NumberA88690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: