Shawn Shu Wern Koh, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A109890 Issued in CA

Practice address

400 N Pepper Ave
Colton, CA 92324-1801

Phone

(909) 580-1000

NPI assigned

May 12, 2008

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1669649562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 VIOLET ST",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241603",
            "telephone_number": "909-580-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "SHAWN",
        "middle_name": "SHU WERN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-12",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A109890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorene Pasillas Kloby
• KNB Pharmacy Inc (Cooley Health Pharmacy)
• Christie Knox, D.O.
• Gregory L Knutzen, NP
• Ellen C Ko, M.D.
• Carole Gail Kohen-Diniak, D O
• Kamilah Koleszar
• Robert Sexton Kollen, M.D
• Chuck S Kon, D.D.S.
• Sabrina Katrina Koperski

• Internal Medicine Physician in Colton, CA
• Providers in Colton, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.