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Organization

GRANT N KO MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRANT NORMAN KO MD (OWNER)
(707) 800-7700
Entity
Organization

Contact information

Practice address
1287 FULTON RD, SANTA ROSA, CA 95401-4923
(707) 800-7700
(707) 800-7799
Mailing address
PO BOX 1770, LA MESA, CA 91944-1770
(707) 800-7700
(707) 800-7799

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G49179
CA

Other

Enumeration date
08/09/2017
Last updated
08/09/2017
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