Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 217683 | MA |
N | 111NI0900X | Internist | 217683 | MA |
Y | 207RG0100X | Gastroenterologist | A100119 | CA |
NPI | 1043296866 |
---|---|
Provider Name | Pilsoo Oh |
First Address | Los Angeles, CA 90020 |
Second Address | Los Angeles, CA 90020-1416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 28/09/2010 |