Healthcare Provider Details

I. General information

NPI: 1043202120
Provider Name (Legal Business Name): DAVID T KUO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 S MARYLAND PKWY
LAS VEGAS NV
89109-2204
US

IV. Provider business mailing address

PO BOX 36900
LAS VEGAS NV
89133-6900
US

V. Phone/Fax

Practice location:
  • Phone: 702-732-6000
  • Fax: 702-243-7531
Mailing address:
  • Phone: 702-732-6000
  • Fax: 702-243-7531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1058
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: