Provider Demographics
NPI:1295016475
Name:KO, BRYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:
Last Name:KO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51351
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92619-1351
Mailing Address - Country:US
Mailing Address - Phone:310-597-9146
Mailing Address - Fax:
Practice Address - Street 1:11500 BROOKSHIRE AVE
Practice Address - Street 2:PIH HEALTH DOWNEY - DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4917
Practice Address - Country:US
Practice Address - Phone:562-904-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111956207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine