Healthcare Provider Details

I. General information

NPI: 1316141757
Provider Name (Legal Business Name): SHIH-YUN GLORIA KUO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 SPRY AVE
LAS VEGAS NV
89123-3550
US

IV. Provider business mailing address

337 SPRY AVE
LAS VEGAS NV
89123-3550
US

V. Phone/Fax

Practice location:
  • Phone: 702-616-3362
  • Fax: 702-492-1736
Mailing address:
  • Phone: 702-616-3362
  • Fax: 702-492-1736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14372
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: