Healthcare Provider Details

I. General information

NPI: 1609954825
Provider Name (Legal Business Name): CALVIN KUO M.D. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 CAMPUS DR DEPARTMENT OF HEMATOLOGY - CCSR 1155
STANFORD CA
94305-5101
US

IV. Provider business mailing address

269 CAMPUS DR CCSR 1155
STANFORD CA
94305-5101
US

V. Phone/Fax

Practice location:
  • Phone: 650-736-1428
  • Fax:
Mailing address:
  • Phone: 650-736-1428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberG86636
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: