Choon Sil Koo, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

A31561 Issued in CA

Practice address

999 San Bernardino Rd
Upland, CA 91786-4920

Phone

(909) 985-2811

Fax

(909) 920-3827

NPI assigned

Sep 13, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Other, 1968

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excel PathologyGroup PAC ID 9436522646, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099
• Mountains Community Hospital Hospital, Lake Arrowhead, CA, CCN 051312

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Excel Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Upland, CA
  • NPI 1053022277
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  Care Compare affiliation
• San Bernardino Mountains Community Hospital District

  dba Mountains Community Hospital

  • Critical Access Hospital
  • Lake Arrowhead, CA
  • NPI 1245380799
  Care Compare affiliation

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265427595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2311",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913132311",
            "telephone_number": "818-718-9500",
            "fax_number": "818-718-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 SAN BERNARDINO RD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864920",
            "telephone_number": "909-985-2811",
            "fax_number": "909-920-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "CHOON",
        "middle_name": "SIL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A31561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A315610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith A. Koerner, LMFT
• Morris Kokhab, M.D.
• Robert James Kolesnik, MD
• Bhupal Kommineni, MD FACP
• Sean Shukue Kono, D.C.
• Kopper Imaging
• Nabil Koudsi, MD
• Melissa Duran Kramer, FNP
• Sydnee Rose Krattenmaker
• Robert Steven Kratz

• Anatomic Pathology & Clinical Pathology Physician in Upland, CA
• Providers in Upland, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.