MEDICARE: DR. DAVID WAYNE KUO D.C.

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	111NI0900X	Internist Chiropractor	24460	CA

General Provider Information

NPI Number	:	1841295961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID WAYNE KUO D.C.

Provider Business Mailing Address
First Line	:	151 S EL MOLINO AVE
Second Line	:	STE 301
City	:	PASADENA
State	:	CA
Zip	:	91101-2562
Country	:	US
Telephone Number	:	626-449-0510
Fax Number	:	626-449-1640

Provider Business Practice Location Address
First Line	:	151 S EL MOLINO AVE
Second Line	:	STE 301
City	:	PASADENA
State	:	CA
Zip	:	91101-2562
Country	:	US
Telephone Number	:	626-449-0510
Fax Number	:	626-449-1640

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/08/2007

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