Provider Demographics
NPI:1851396469
Name:KUO, TOMMY TZU-FONG (MD)
Entity Type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:TZU-FONG
Last Name:KUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1 BAYWOOD AVE
Mailing Address - Street 2:STE 8
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1537
Mailing Address - Country:US
Mailing Address - Phone:650-348-7375
Mailing Address - Fax:650-348-7069
Practice Address - Street 1:1 BAYWOOD AVE
Practice Address - Street 2:STE 8
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1537
Practice Address - Country:US
Practice Address - Phone:650-348-7375
Practice Address - Fax:650-348-7069
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72386207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G723860Medicare ID - Type Unspecified
CAF70619Medicare UPIN