Active NPI
Kyoo Sang Ro, M.D.
- Neurological Surgery Physician
- Glendale, CA
National Provider Identifier
1083613897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- A26079A
- Practice address
- 435 Arden Ave
380
Glendale, CA 91203-1130 - Phone
- (818) 240-5241
- Fax
- (818) 240-8264
- NPI assigned
- Jul 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | A26079A | CA | Primary |
Addresses
Primary practice location
435 Arden Ave
380
Glendale, CA 91203-1130
Mailing address
435 Arden Ave
Suite 380
Glendale, CA 91203-1130
Phone (818) 240-5241
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A26079 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A26079A | CA | MD | Neurological Surgery Physician |
Interoperability endpoints
- kyooro@fksr.ssdirect.aprima.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1083613897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "435 ARDEN AVE",
"address_2": "SUITE 380",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912031130",
"telephone_number": "818-240-5241",
"fax_number": "818-240-8264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 ARDEN AVE",
"address_2": "380",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912031130",
"telephone_number": "818-240-5241",
"fax_number": "818-240-8264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RO",
"first_name": "KYOO",
"middle_name": "SANG",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "CA",
"license": "A26079A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A26079",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.