Healthcare Provider Details

I. General information

NPI: 1861478422
Provider Name (Legal Business Name): SAMUEL S KUO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 N CHERRY ST
TULARE CA
93274-2251
US

IV. Provider business mailing address

1088 N CHERRY ST
TULARE CA
93274-2251
US

V. Phone/Fax

Practice location:
  • Phone: 559-688-8899
  • Fax: 559-688-8889
Mailing address:
  • Phone: 559-688-8899
  • Fax: 559-688-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA42858
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: