Provider Demographics
NPI:1609095017
Name:KUO, CINDY YUNG-FANG (DO)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:YUNG-FANG
Last Name:KUO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 EXPRESS CIR
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-6229
Mailing Address - Country:US
Mailing Address - Phone:626-226-7424
Mailing Address - Fax:
Practice Address - Street 1:111 N SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6861
Practice Address - Country:US
Practice Address - Phone:310-379-2134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8907207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine