Healthcare Provider Details

I. General information

NPI: 1518118116
Provider Name (Legal Business Name): ANLEE D KUO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3841 24TH ST
SAN FRANCISCO CA
94114-3810
US

IV. Provider business mailing address

3841 24TH ST
SAN FRANCISCO CA
94114-3810
US

V. Phone/Fax

Practice location:
  • Phone: 415-516-3621
  • Fax: 415-642-1540
Mailing address:
  • Phone: 415-516-3621
  • Fax: 415-642-1540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA69776
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA69776
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: