Provider Demographics
NPI:1144414541
Name:KUO, JIMMY TUNG-YEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:TUNG-YEE
Last Name:KUO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17211 CHATSWORTH ST
Mailing Address - Street 2:#27
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5774
Mailing Address - Country:US
Mailing Address - Phone:818-832-5291
Mailing Address - Fax:
Practice Address - Street 1:17211 CHATSWORTH ST
Practice Address - Street 2:#27
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5774
Practice Address - Country:US
Practice Address - Phone:818-832-5291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist