Provider Demographics
NPI:1801189048
Name:KO, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:KO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:310-391-7281
Mailing Address - Fax:310-301-8751
Practice Address - Street 1:11303 W WASHINGTON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6003
Practice Address - Country:US
Practice Address - Phone:310-391-7281
Practice Address - Fax:310-301-8751
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2017-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA131980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine