Healthcare Provider Details

I. General information

NPI: 1750615472
Provider Name (Legal Business Name): TSENG-YIN KUO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 03/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1046 POLK LN
SAN JOSE CA
95117-2943
US

IV. Provider business mailing address

1046 POLK LN
SAN JOSE CA
95117-2943
US

V. Phone/Fax

Practice location:
  • Phone: 408-858-8047
  • Fax: 408-865-1438
Mailing address:
  • Phone: 408-858-8047
  • Fax: 408-865-1438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number741114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: