Provider Demographics
NPI:1477637049
Name:KUO, TERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:
Last Name:KUO
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 1:880 S ATLANTIC BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4772
Mailing Address - Country:US
Mailing Address - Phone:626-281-6969
Mailing Address - Fax:626-281-2089
Practice Address - Street 1:880 S ATLANTIC BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4772
Practice Address - Country:US
Practice Address - Phone:626-281-6969
Practice Address - Fax:626-281-2089
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG077602207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA582658Medicare UPIN