Healthcare Provider Details

I. General information

NPI: 1306341532
Provider Name (Legal Business Name): CHIA-HSUAN KUO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 CAMINO RAMON
SAN RAMON CA
94583-4285
US

IV. Provider business mailing address

251 BRANDON ST APT 194
SAN JOSE CA
95134-3664
US

V. Phone/Fax

Practice location:
  • Phone: 925-327-6136
  • Fax:
Mailing address:
  • Phone: 512-767-0261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number83610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: