Individual
JAHOON KOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 COFFEE RD, MODESTO, CA 95355
(209) 579-5628
(209) 579-5637
Mailing address
220 STANDIFORD AVE STE F, MODESTO, CA 95350-1159
(209) 579-5628
(209) 579-5637
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A140169
CA
2086S0127X
Trauma Surgery Physician
A140169
CA
Other
Enumeration date
04/09/2014
Last updated
11/11/2019
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