Provider Demographics
NPI:1841277019
Name:KOO, CHA OEOK (MD)
Entity type:Individual
Prefix:
First Name:CHA
Middle Name:OEOK
Last Name:KOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:18TH MEDICAL COMMAND
Mailing Address - Street 2:BOX 68 UNIT 15821
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-5281
Mailing Address - Country:KR
Mailing Address - Phone:0118227-917-7172
Mailing Address - Fax:0118227-916-8005
Practice Address - Street 1:18TH MEDICAL COMMAND
Practice Address - Street 2:BOX 68 UNIT 15821
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-5281
Practice Address - Country:KR
Practice Address - Phone:0118227-917-7172
Practice Address - Fax:0118227-916-8005
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
PAMD017416E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry