Organization
KER YONG JUSTINE KOH MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KER YONG JUSTINE KOH MD (PRESIDENT)
(559) 436-0871
Entity
Organization
Contact information
Practice address
1441 FLORIDA AVE, MODESTO, CA 95350-4405
(209) 576-3514
(559) 436-5221
Mailing address
PO BOX 28128, FRESNO, CA 93729-8128
(559) 436-0871
(559) 436-5221
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C140941
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083775787
NPI
—
Enumeration date
06/01/2017
Last updated
06/01/2017
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