Provider Demographics
NPI:1588600993
Name:KUO, KANE E (MD)
Entity Type:Individual
Prefix:DR
First Name:KANE
Middle Name:E
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 1:3330 LOMITA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5002
Mailing Address - Country:US
Mailing Address - Phone:310-517-4616
Mailing Address - Fax:310-784-8777
Practice Address - Street 1:3330 LOMITA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5002
Practice Address - Country:US
Practice Address - Phone:310-517-4616
Practice Address - Fax:310-784-8777
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84582207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A845820OtherBLUE SHIELD
CA050359CI43021OtherTULARE TRAILBLAZER
CA00A845820OtherCALOPTIMA
CAA84582OtherBLUE CROSS
CAP00270575OtherTULARE RAILROAD
CA00A845820Medicaid
CA00A845820OtherCALOPTIMA
CA050359CI43021OtherTULARE TRAILBLAZER