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Individual
DAVIS KOH
Active
Individual
DAVIS KOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT21306
CA
2251S0007X
Sports Physical Therapist
—
CA
2251X0800X
Orthopedic Physical Therapist
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00197420
RAILROAD MEDICARE
CA
01
—
PT0213060
BLUE SHIELD
CA
05
—
PT0213060
—
CA
01
—
PT21306
STATE LICENSE NUMBER
CA
Enumeration date
07/10/2006
Last updated
09/15/2026
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