MEDICARE: ANTHONY J CUOMO MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1255430369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY J CUOMO MD INC

Provider Business Mailing Address
First Line	:	6699 ALVARADO RD
Second Line	:	SUITE 2308
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5241
Country	:	US
Telephone Number	:	619-462-9010
Fax Number	:	619-287-9058

Provider Business Practice Location Address
First Line	:	6699 ALVARADO RD
Second Line	:	SUITE 2308
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5241
Country	:	US
Telephone Number	:	619-462-9010
Fax Number	:	619-287-9058

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANTHONY JOHN CUOMO
Credential	:	M.D.
Telephone Number	:	619-462-9010

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	12/20/2007

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