Individual
ERIC KOGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
4900 ROSELIN WAY, ELK GROVE, CA 95758-4145
(916) 837-2417
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
NA
NM
Other
Enumeration date
06/06/2019
Last updated
06/06/2019
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