Provider Demographics
NPI:1942501713
Name:A. KO, M.D., INC.
Entity Type:Organization
Organization Name:A. KO, M.D., INC.
Other - Org Name:BRISTOL PEDIATRICS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:P
Authorized Official - Last Name:KO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-979-7788
Mailing Address - Street 1:11100 WARNER AVE STE 262
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7512
Mailing Address - Country:US
Mailing Address - Phone:714-979-7788
Mailing Address - Fax:714-979-7799
Practice Address - Street 1:11100 WARNER AVE STE 262
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7512
Practice Address - Country:US
Practice Address - Phone:714-979-7788
Practice Address - Fax:714-979-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76901208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty