Healthcare Provider Details

I. General information

NPI: 1306931555
Provider Name (Legal Business Name): ANGEL CHEN KUO RN, MSN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/11/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 4TH ST. PEDIATRIC UROLOGY
SAN FRANCISCO CA
94158
US

IV. Provider business mailing address

1825 4TH ST. PEDIATRIC UROLOGY
SAN FRANCISCO CA
94158
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-8383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number10154
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: