Healthcare Provider Details

I. General information

NPI: 1003840562
Provider Name (Legal Business Name): DAVIS KOH PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9080 IRVINE CENTER DR
IRVINE CA
92618-4658
US

IV. Provider business mailing address

9080 IRVINE CENTER DR
IRVINE CA
92618-4658
US

V. Phone/Fax

Practice location:
  • Phone: 949-540-5641
  • Fax:
Mailing address:
  • Phone: 949-540-5641
  • Fax: 949-540-5642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: