Healthcare Provider Details

I. General information

NPI: 1851396469
Provider Name (Legal Business Name): TOMMY TZU-FONG KUO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BAYWOOD AVE STE 8
SAN MATEO CA
94402-1537
US

IV. Provider business mailing address

1 BAYWOOD AVE STE 8
SAN MATEO CA
94402-1537
US

V. Phone/Fax

Practice location:
  • Phone: 650-348-7375
  • Fax: 650-348-7069
Mailing address:
  • Phone: 650-348-7375
  • Fax: 650-348-7069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG72386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: