Provider Demographics
NPI:1083966741
Name:KUO, ZHENG-JIE (LAC)
Entity Type:Individual
Prefix:
First Name:ZHENG-JIE
Middle Name:
Last Name:KUO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 87TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1754
Mailing Address - Country:US
Mailing Address - Phone:415-636-7345
Mailing Address - Fax:
Practice Address - Street 1:307 87TH ST STE C
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1754
Practice Address - Country:US
Practice Address - Phone:415-636-7345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15012171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist