Provider Demographics
NPI:1548338189
Name:KUO, NORMAN (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:
Last Name:KUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5471 LA PALMA AVE
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1745
Mailing Address - Country:US
Mailing Address - Phone:714-521-0239
Mailing Address - Fax:714-521-0218
Practice Address - Street 1:5471 LA PALMA AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1745
Practice Address - Country:US
Practice Address - Phone:714-521-0239
Practice Address - Fax:714-521-0218
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37079207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A370791Medicaid
CAA84962Medicare UPIN
CAA37079AMedicare ID - Type Unspecified