1144245606

Everything you always wanted to know about DR. KOO H EDWARD M.D. but were afraid to ask.

DR. KOO H EDWARD M.D.

You can also download the this 1144245606 data report as csv | excel | json | xml
Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
DR. KOO H EDWARD M.D.
Gender:
Male
Enumeration date:
2006-07-13
Last update date:
2007-07-08
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state
E35814 Medicare UPIN none CA
WG47266A Medicare ID-Type Undpecified none CA
00G472660 Medicaid none CA

Taxonomies

Taxonomy State License Number Primary?
207ZN0500X Neuropathology CA G47266 X
2084N0400X Neurology CA G47266 X

Phone Numbers

Type Number
Mailing Address Telephone Number 8588221024
Practice Location Address Telephone Number 8588221024
Mailing Address Fax Number 8588221021
Practice Location Address Fax Number 8588221021

Addresses

Type Address City State Postal Country
Mailing Address 9500 GILMAN DR MAIL CODE 0691 LA JOLLA CA 92093 CA
Practice Location Address 9500 GILMAN DR MAIL CODE 0691 LA JOLLA CA 92093 CA

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