Provider Demographics
NPI:1467643940
Name:WILLIAM WENG-PING KO, M.D. A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:WILLIAM WENG-PING KO, M.D. A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:WENG PING
Authorized Official - Last Name:KO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-284-2168
Mailing Address - Street 1:117 S MISSION DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1101
Mailing Address - Country:US
Mailing Address - Phone:626-284-2168
Mailing Address - Fax:626-284-7980
Practice Address - Street 1:117 S MISSION DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1101
Practice Address - Country:US
Practice Address - Phone:626-284-2168
Practice Address - Fax:626-284-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN
CA4409940001Medicare NSC