Provider Demographics
NPI:1437663697
Name:STEPHANIE KUA, MD INC
Entity Type:Organization
Organization Name:STEPHANIE KUA, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:RODRIGUEZ
Authorized Official - Last Name:KUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-424-7582
Mailing Address - Street 1:7015 OREGON ST
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3624
Mailing Address - Country:US
Mailing Address - Phone:714-624-8777
Mailing Address - Fax:
Practice Address - Street 1:17744 SKY PARK CIR STE 285
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-4461
Practice Address - Country:US
Practice Address - Phone:949-424-7582
Practice Address - Fax:949-627-2582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty