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Individual

KILSAN KOH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1000 ALPINE AVE, SUITE 210, BOULDER, CO 80304-3406
(303) 443-1008
(303) 417-1111
Mailing address
1000 ALPINE AVE, SUITE 210, BOULDER, CO 80304-3406
(303) 443-1008
(303) 417-1111

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
29339
CO
208600000X
Surgery Physician
G87774
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
O1293398
CO
Enumeration date
09/16/2006
Last updated
12/15/2010
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