Organization
KENNETH M SOOHOO MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH SOOHOO M.D. (DIRECT OWNER)
(818) 888-7815
Entity
Organization
Contact information
Practice address
18300 ROSCOE BLVD, NORTHRIDGE, CA 91325-4105
(818) 885-8500
(818) 715-1722
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G63312
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
G63312
CA
Other
Enumeration date
03/29/2006
Last updated
12/15/2009
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