Healthcare Provider Details

I. General information

NPI: 1689585127
Provider Name (Legal Business Name): EMILY LEE KO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16111 PLUMMER ST
NORTH HILLS CA
91343-2036
US

IV. Provider business mailing address

3350 WILSHIRE BLVD APT 815N
LOS ANGELES CA
90010-4208
US

V. Phone/Fax

Practice location:
  • Phone: 310-998-7938
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT310926
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: