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Individual

KO GENG LIUO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1200 N MAIN ST, #650, SANTA ANA, CA 92701-3640
(714) 824-8140
Mailing address
35 FIELD, #650, IRVINE, CA 92620-3345
(949) 981-4515

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95001948
CA

Other

Enumeration date
03/06/2015
Last updated
01/11/2017
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