Provider Demographics
NPI:1417057373
Name:KOH, KEE S (MD)
Entity Type:Individual
Prefix:DR
First Name:KEE
Middle Name:S
Last Name:KOH
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 1:612 W DUARTE RD STE 401
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9233
Mailing Address - Country:US
Mailing Address - Phone:626-821-9892
Mailing Address - Fax:626-446-1620
Practice Address - Street 1:612 W DUARTE RD STE 401
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9233
Practice Address - Country:US
Practice Address - Phone:626-821-9892
Practice Address - Fax:626-446-1620
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30888207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A308880Medicaid
CAA30888Medicare PIN
CA00A308880Medicaid