Provider Demographics
NPI:1376712844
Name:JOSE S. KUA M.D. FACOG INC.
Entity Type:Organization
Organization Name:JOSE S. KUA M.D. FACOG INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:SIA
Authorized Official - Last Name:KUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-633-5091
Mailing Address - Street 1:16415 COLORADO AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5053
Mailing Address - Country:US
Mailing Address - Phone:562-633-5091
Mailing Address - Fax:562-633-7857
Practice Address - Street 1:16415 COLORADO AVE STE 305
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5053
Practice Address - Country:US
Practice Address - Phone:562-633-5091
Practice Address - Fax:562-633-7857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A309190Medicaid