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General NPI Number Information
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NPI Number | 1700837937
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Entity Type | Organization
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Legal Business Name | GENE KYO OH MD INC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 12900A GARDEN GROVE BLVD #122
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City | GARDEN GROVE
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State | CA
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Zip | 92843
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Country | US
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Telephone | 714-636-0342
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Fax | 714-636-0391
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Provider Business Mailing Address
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Address Line | PO BOX 775
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City | GARDEN GROVE
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State | CA
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Zip | 92842
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Country | US
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Telephone | 714-636-0342
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Fax | 714-636-0391
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Authorized Official
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Title or Position | PRESIDENT
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Name | GENE KYO OH
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Credential | MD
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Telephone | 714-998-8133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A26489
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License Number State | CA
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