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General NPI Number Information
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NPI Number | 1174029821
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Entity Type | Individual
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Provider Name | SELENA ZHAO KUO
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Gender | Female
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 9350 CAMPUS POINT DR
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City | LA JOLLA
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State | CA
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Zip | 92037-1300
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Country | US
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Telephone | 800-926-8273
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Fax |
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Provider Business Mailing Address
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Address Line | FILE 57326
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City | LOS ANGELES
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State | CA
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Zip | 90074-0001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0008X
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Taxonomy Name | Hepatology Physician
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License Number | A174239
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A174239
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License Number State | CA
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