Active NPI
Kristine Koh, MD
- Emergency Medicine Physician
- Fullerton, CA
National Provider Identifier
1598712614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- G77835
- Practice address
- 101 E Valencia Mesa
Fullerton, CA 92835 - Phone
- (714) 992-3965
- NPI assigned
- May 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | G77835 | CA | Primary |
Addresses
Primary practice location
101 E Valencia Mesa
Fullerton, CA 92835
Mailing address
PO Box 5809
Fullerton, CA 92838-0809
Phone (562) 809-3574
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G778350 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1598712614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5809",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928380809",
"telephone_number": "562-809-3574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E VALENCIA MESA",
"city": "FULLERTON",
"state": "CA",
"postal_code": "92835",
"telephone_number": "714-992-3965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOH",
"first_name": "KRISTINE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-27",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "G77835",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G778350",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.