MEDICARE: DR. ERIC KUO DDS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	43540	CA

General Provider Information

NPI Number	:	1881628923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC KUO DDS

Provider Business Mailing Address
First Line	:	2001 UNION ST STE 664
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-4111
Country	:	US
Telephone Number	:	415-775-5774
Fax Number	:	415-921-2890

Provider Business Practice Location Address
First Line	:	2001 UNION ST STE 664
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-4111
Country	:	US
Telephone Number	:	415-775-5774
Fax Number	:	415-921-2890

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	09/25/2008

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