Organization
MARTHA B. KOO, M.D., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA KOO M.D. (PRESIDENT)
(310) 318-2566
Entity
Organization
Contact information
Practice address
2615 PACIFIC COAST HWY, 215, HERMOSA BEACH, CA 90254-2225
(310) 318-2566
Mailing address
515 LARSSON ST, MANHATTAN BEACH, CA 90266-6734
(310) 318-2566
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
G78080
CA
Other
Enumeration date
09/03/2007
Last updated
09/03/2007
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