Provider Demographics
NPI:1710999867
Name:KO, BELINDA YAH-SHIN (MD)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:YAH-SHIN
Last Name:KO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3919 W 242ND ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6474
Mailing Address - Country:US
Mailing Address - Phone:310-228-7969
Mailing Address - Fax:
Practice Address - Street 1:1821 WILSHIRE BLVD STE 301
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5679
Practice Address - Country:US
Practice Address - Phone:310-575-3100
Practice Address - Fax:310-575-3102
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82795207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A827950Medicare UPIN