Provider Demographics
NPI:1073524468
Name:KAO, MICHAEL CHUN-YUEN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CHUN-YUEN
Last Name:KAO
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 1:8333 CLAIREMONT MESA BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1318
Mailing Address - Country:US
Mailing Address - Phone:858-266-8300
Mailing Address - Fax:858-266-8301
Practice Address - Street 1:8333 CLAIREMONT MESA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1318
Practice Address - Country:US
Practice Address - Phone:858-266-8300
Practice Address - Fax:858-266-8301
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55082207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG55082AMedicare PIN
F81898Medicare UPIN