Organization Active NPI

Gemma TH Ko,MD. Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
National Provider Identifier
1184633620
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G70866 Issued in CA
Legal business name
GEMMA TH KO,MD. INC.
Practice address
4511 Rosemead Blvd
Pico Rivera, CA 90660-2032
Phone
(562) 692-3388
NPI assigned
Aug 5, 2006
Last updated
Feb 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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

Authorized official

Name
Dr. Michele Mary Guzman
Title
Office Manager
Phone
(562) 692-3388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G70866 CA Primary

Addresses

Primary practice location

4511 Rosemead Blvd
Pico Rivera, CA 90660-2032

Mailing address

4511 Rosemead Blvd
Pico Rivera, CA 90660-2032
Phone (562) 692-3388

Other identifiers 1

IdentifierTypeStateIssuer
00G708660MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614001450 CA Part B Supplier - Clinic/Group Practice 2567406168 Receives reassigned benefits from 2 practitioners
Practice locations: Pico Rivera, CA

National Provider Directory

National Provider Directory

Locations

433 N 4th St
Ste 219
Montebello, CA 90640
Phone (213) 721-5193

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1184633620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 ROSEMEAD BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602032",
            "telephone_number": "562-692-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 ROSEMEAD BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602032",
            "telephone_number": "562-692-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEMMA TH KO,MD. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "GUZMAN",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "562-692-3388",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G70866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G708660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pico Rivera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.