Healthcare Provider Details

I. General information

NPI: 1255867321
Provider Name (Legal Business Name): DAVID KUO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2017
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 COTTLE RD BLDG 22
SAN JOSE CA
95123-3640
US

IV. Provider business mailing address

5755 COTTLE RD BLDG 22
SAN JOSE CA
95123-3640
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-6570
  • Fax:
Mailing address:
  • Phone: 408-972-6570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number160529
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: