Soochung Ko, L.AC., DIPL. O.M.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC11366 Issued in CA

Practice address

4400 Keller Ave
Suite 250
Oakland, CA 94605-4281

Phone

(510) 282-0174

NPI assigned

Apr 8, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Ko Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1205959038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 KELLER AVE",
            "address_2": "SUITE 250",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054281",
            "telephone_number": "510-632-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 KELLER AVE",
            "address_2": "SUITE 250",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946054281",
            "telephone_number": "510-282-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "SOOCHUNG",
        "credential": "L.AC., DIPL. O.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-08",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "KO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anthony C. Ko, MD
• Caroline J Ko, DPM
• Hyung Kwon Ko, DMD
• Jimmy Ko, MD
• Kenneth Ko
• Wynne S Ko, DDS
• Jared Kobliska
• Vanessa Kobza, MS, RD, CSP
• Grace C Kodama, MFT, LPCC
• Rachel Nyleen Koebele, DPT

• Acupuncturist in Oakland, CA
• Providers in Oakland, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.