Individual
MR. DOMINIC E. B. KOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPNP, ANP-C
Contact information
Practice address
1530 HILLHURST AVE, LOS ANGELES, CA 90027-5516
(323) 644-3880
(323) 644-3892
Mailing address
2571 ROCHELLE AVE, MONROVIA, CA 91016-4941
(626) 303-3950
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
RN476192, NPF 8506
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN476192, NPF 8506
CA
Other
Enumeration date
05/27/2005
Last updated
07/06/2010
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