Healthcare Provider Details

I. General information

NPI: 1447606686
Provider Name (Legal Business Name): YEN-CHEN KUO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2098 WALSH AVE STE B
SANTA CLARA CA
95050-2544
US

IV. Provider business mailing address

2098 WALSH AVE STE B
SANTA CLARA CA
95050-2544
US

V. Phone/Fax

Practice location:
  • Phone: 408-753-0935
  • Fax: 669-235-8797
Mailing address:
  • Phone: 408-753-0935
  • Fax: 669-235-8797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number33524
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: