Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 13521 | CA |
NPI | 1053638775 |
---|---|
Provider Name | Mrs. Yumui Ko |
First Address | Garden Grove, CA 92844-2662 |
Second Address | Garden Grove, CA 92844-2984 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2010 |
Last Update Date | 21/04/2010 |