Healthcare Provider Details

I. General information

NPI: 1679952816
Provider Name (Legal Business Name): WENHAO CEDRIC KUO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 06/15/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST STE 824
HONOLULU HI
96826-1032
US

IV. Provider business mailing address

95-390 KUAHELANI AVE
MILILANI HI
96789-1192
US

V. Phone/Fax

Practice location:
  • Phone: 808-203-6518
  • Fax:
Mailing address:
  • Phone: 808-627-3254
  • Fax: 808-627-3265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDOSR-330
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: