Individual
DR. PETER J KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1207 FAIRCHILD CT, WOODLAND, CA 95695-4321
(530) 666-1631
(530) 661-2410
Mailing address
3 EL DORADO CT, WOODLAND, CA 95695-5218
(530) 662-0354
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G36013
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G360130
BLUE SHIELD
CA
05
—
00G360130
—
CA
Enumeration date
07/19/2006
Last updated
07/09/2007
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