Provider Demographics
NPI:1073148474
Name:KOO, ARNOLD (DC)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:
Last Name:KOO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6654 KOLL CENTER PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-3123
Mailing Address - Country:US
Mailing Address - Phone:925-396-8004
Mailing Address - Fax:925-396-8005
Practice Address - Street 1:6654 KOLL CENTER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-3123
Practice Address - Country:US
Practice Address - Phone:925-396-8004
Practice Address - Fax:925-396-8005
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor