John J Koo MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD-14092 Issued in HI

Legal business name

JOHN J KOO MD INC

Practice address

640 Ulukahiki St
Kailua, HI 96734-4454

Phone

(808) 263-5500

NPI assigned

May 23, 2011

Organization subpart

No

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

Authorized official

Name

Dr. John J Koo, M.D.NPI 1477617561

Title

Owner

Phone

(808) 352-1981

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

Locations

Practitioners 1

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

• John J Koo, MD

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1477617561

  HI

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306108800000",
    "number": "1275826307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25490",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968250490",
            "telephone_number": "808-536-0300",
            "fax_number": "808-536-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ULUKAHIKI ST",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967344454",
            "telephone_number": "808-263-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J KOO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-23",
        "last_updated": "2011-05-23",
        "status": "A",
        "authorized_official_last_name": "KOO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-352-1981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-14092",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "HI",
            "license": "MD-14092",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "591041",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Kailua, HI
• Providers in Kailua, HI by specialty
• Internal Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2011; 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.