Provider Demographics
NPI:1902006588
Name:OH, KAREN EUNKYUNG (DO)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:EUNKYUNG
Last Name:OH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:EUNKYUNG
Other - Last Name:OH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:23000 CRENSHAW BLVD.
Mailing Address - Street 2:SUITE #208
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505
Mailing Address - Country:US
Mailing Address - Phone:310-326-1147
Mailing Address - Fax:310-326-1148
Practice Address - Street 1:23000 CRENSHAW BLVD.
Practice Address - Street 2:SUITE #208
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-326-1147
Practice Address - Fax:310-326-1148
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5905207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF74020Medicare UPIN
CAW1869Medicare PIN