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General NPI Number Information
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NPI Number | 1104694850
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Entity Type | Organization
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Legal Business Name | JOSEPH K KOO MD
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/23/2023
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Provider Practice Location Address
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Address Line | 321 N KUAKINI ST
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City | HONOLULU
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State | HI
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Zip | 96817-2364
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Country | US
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Telephone | 808-523-6461
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 57
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City | HONOLULU
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State | HI
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Zip | 96810-0057
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH K KOO
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Credential | MD
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Telephone | 808-722-1280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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