MEDICARE: DR. ANN KUO M.D.

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	207RH0003X	Hematology & Oncology Physician	A127529	CA
2	207R00000X	Internal Medicine Physician	A127529	CA

General Provider Information

NPI Number	:	1790030005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN KUO M.D.

Provider Business Mailing Address
First Line	:	10790 RANCHO BERNARDO RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-5705
Country	:	US
Telephone Number	:	619-849-4469
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 WASHINGTON ST STE 508
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2238
Country	:	US
Telephone Number	:	619-849-4469
Fax Number	:	619-849-1547

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2012
Last Update Date	:	09/28/2021

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