Provider Demographics
NPI:1003859059
Name:KUO, PHILIP IEE-LIAN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:IEE-LIAN
Last Name:KUO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 ULUNIU ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2517
Mailing Address - Country:US
Mailing Address - Phone:808-261-8345
Mailing Address - Fax:808-262-5239
Practice Address - Street 1:414 ULUNIU ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2517
Practice Address - Country:US
Practice Address - Phone:808-261-8345
Practice Address - Fax:808-262-5239
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD12315207K00000X, 207R00000X, 207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH55464Medicare PIN
HIH83345Medicare UPIN