Provider Demographics
NPI:1922102052
Name:KOH, STEVE S (MD)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:S
Last Name:KOH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44105 15TH ST W
Mailing Address - Street 2:#302, ANTELOPE VALLEY UROLOGY
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4088
Mailing Address - Country:US
Mailing Address - Phone:661-949-3006
Mailing Address - Fax:661-949-8700
Practice Address - Street 1:44105 15TH ST W
Practice Address - Street 2:#302, ANTELOPE VALLEY UROLOGY
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4088
Practice Address - Country:US
Practice Address - Phone:661-949-3006
Practice Address - Fax:661-949-8700
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC39635208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0076830Medicaid
A37184Medicare UPIN
CAGR0076830Medicaid