Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A34654 | CA |
NPI | 1366585333 |
---|---|
Provider Name | Indong Oh |
First Address | Pasadena, CA 91105-3132 |
Second Address | Pasadena, CA 91105-3132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 06/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A346540 | (05) | CA |
A27545 | (02) | CA |