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General NPI Number Information
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NPI Number | 1134364748
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Entity Type | Organization
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Legal Business Name | SANDY S KOH M.D., INC
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 2727 PECK RD
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City | EL MONTE
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State | CA
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Zip | 91733-2434
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Country | US
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Telephone | 626-350-2196
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Fax | 626-350-4030
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Provider Business Mailing Address
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Address Line | 3419 TYLER AVE
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City | EL MONTE
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State | CA
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Zip | 91731-3103
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Country | US
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Telephone | 626-350-2197
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Fax | 626-350-2111
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANDY S KOH
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Credential | M.D.
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Telephone | 626-350-2196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A34583
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License Number State | CA
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