Provider Demographics
NPI:1902956345
Name:KUOCH, DAVID J (LAC, MTOM)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:KUOCH
Suffix:
Gender:M
Credentials:LAC, MTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5553 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-3919
Mailing Address - Country:US
Mailing Address - Phone:323-930-9355
Mailing Address - Fax:323-930-9375
Practice Address - Street 1:5553 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-3919
Practice Address - Country:US
Practice Address - Phone:323-930-9355
Practice Address - Fax:323-930-9375
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11466171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist