Provider Demographics
NPI:1922773118
Name:KUO, WEI CHUNG (PT, DPT)
Entity Type:Individual
Prefix:
First Name:WEI CHUNG
Middle Name:
Last Name:KUO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16514 OLD FOREST RD
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-3746
Mailing Address - Country:US
Mailing Address - Phone:626-715-4932
Mailing Address - Fax:
Practice Address - Street 1:16514 OLD FOREST RD
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-3746
Practice Address - Country:US
Practice Address - Phone:626-715-4932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist