MEDICARE: DR. TOMMY TZU-FONG KUO MD

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	207Q00000X	Family Medicine Physician	G72386	CA

General Provider Information

NPI Number	:	1851396469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TOMMY TZU-FONG KUO MD

Provider Business Mailing Address
First Line	:	1 BAYWOOD AVE
Second Line	:	STE 8
City	:	SAN MATEO
State	:	CA
Zip	:	94402-1537
Country	:	US
Telephone Number	:	650-348-7375
Fax Number	:	650-348-7069

Provider Business Practice Location Address
First Line	:	1 BAYWOOD AVE
Second Line	:	STE 8
City	:	SAN MATEO
State	:	CA
Zip	:	94402-1537
Country	:	US
Telephone Number	:	650-348-7375
Fax Number	:	650-348-7069

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	07/08/2007

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