Provider Demographics
NPI:1841295961
Name:KUO, DAVID WAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WAYNE
Last Name:KUO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 S EL MOLINO AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2562
Mailing Address - Country:US
Mailing Address - Phone:626-449-0510
Mailing Address - Fax:626-449-1640
Practice Address - Street 1:151 S EL MOLINO AVE
Practice Address - Street 2:STE 301
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2562
Practice Address - Country:US
Practice Address - Phone:626-449-0510
Practice Address - Fax:626-449-1640
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24460111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24460BMedicare ID - Type Unspecified