NPIMap

Organization Active NPI

Joshua Kritsada Koh a Professional Psychiatric Corporation

  • Psychiatry Physician
  • San Dimas, CA
National Provider Identifier
1114249240
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A50936 Issued in CA
Legal business name
JOSHUA KRITSADA KOH A PROFESSIONAL PSYCHIATRIC CORPORATION
Practice address
1173 N Dixie Dr
Suite 101
San Dimas, CA 91773-1200
Phone
(909) 599-4422
Fax
(909) 599-5577
NPI assigned
Feb 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joshua Kritsada Koh, M.D.NPI 1871609271
Title
Propietor
Phone
(909) 599-4422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X A50936 CA Primary

Addresses

Primary practice location

1173 N Dixie Dr
Suite 101
San Dimas, CA 91773-1200

Mailing address

2058 N Mills Ave
#518
Claremont, CA 91711-2812
Phone (909) 599-4422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101112000222 CA Part B Supplier - Clinic/Group Practice 8527014992 Receives reassigned benefits from 4 practitioners

National Provider Directory

National Provider Directory

Locations

200 W Paramount St
Azusa, CA 91702
Phone (626) 334-7861

14475 Garden View Ln
Baldwin Park, CA 91706
Phone (626) 962-7095

2053 N Towne Ave
Claremont, CA 91711
Phone (909) 398-4687

715 W Baseline Rd
Claremont, CA 91711
Phone (909) 626-6633

250 N Verdugo Rd
Glendale, CA 91206
Phone (818) 244-1133

409 W Glenoaks Blvd
Glendale, CA 91202
Phone (818) 240-3400

245 S El Molino Ave
Pasadena, CA 91101
Phone (626) 578-0460

1173 N Dixie Dr
Ste 101
San Dimas, CA 91773
Phone (626) 231-7500

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288742400000",
    "number": "1114249240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2058 N MILLS AVE",
            "address_2": "#518",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917112812",
            "telephone_number": "909-599-4422",
            "fax_number": "909-599-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 N DIXIE DR",
            "address_2": "SUITE 101",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731200",
            "telephone_number": "909-599-4422",
            "fax_number": "909-599-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHUA KRITSADA KOH A PROFESSIONAL PSYCHIATRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-11-03",
        "status": "A",
        "authorized_official_last_name": "KOH",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "KRITSADA",
        "authorized_official_title_or_position": "PROPIETOR",
        "authorized_official_telephone_number": "909-599-4422",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A50936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.