Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A116697 | CA |
NPI | 1023081817 |
---|---|
Provider Name | Edmund Yuey Kun Ko |
First Address | Loma Linda, CA 92354-3450 |
Second Address | Loma Linda, CA 92354-3450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 28/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0A1166970 | (05) | CA |
FT272V | (02) | CA |
FT272W | (02) | CA |
FT272X | (02) | CA |