Provider Demographics
NPI:1598024176
Name:KO, LINNA C (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LINNA
Middle Name:C
Last Name:KO
Suffix:
Gender:F
Credentials:PHARM D
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 3357
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91729-3357
Mailing Address - Country:US
Mailing Address - Phone:909-580-0200
Mailing Address - Fax:
Practice Address - Street 1:14555 VALLEY CENTER DR
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-4216
Practice Address - Country:US
Practice Address - Phone:760-524-9911
Practice Address - Fax:760-524-9908
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist