Healthcare Provider Details

I. General information

NPI: 1235548694
Provider Name (Legal Business Name): ANDREW KUO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2014
Last Update Date: 11/25/2023
Certification Date: 11/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST # 10
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1000 W CARSON ST # 10
TORRANCE CA
90502-2004
US

V. Phone/Fax

Practice location:
  • Phone: 424-306-5972
  • Fax:
Mailing address:
  • Phone: 424-306-5972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA141111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: