Provider Demographics
NPI:1912197666
Name:KOH, JOYCE YANG (MD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:YANG
Last Name:KOH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5130 LA JOLLA BLVD
Mailing Address - Street 2:APT 3K
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-1004
Mailing Address - Country:US
Mailing Address - Phone:858-966-5841
Mailing Address - Fax:
Practice Address - Street 1:3020 CHILDRENS WAY
Practice Address - Street 2:MC 5064
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:858-966-5841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106687208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics