Grant N Ko MD PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G49179 Issued in CA

Legal business name

GRANT N KO MD PC

Practice address

1287 Fulton Rd
Santa Rosa, CA 95401-4923

Phone

(707) 800-7700

Fax

(707) 800-7799

NPI assigned

Aug 9, 2017

Organization subpart

No

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

Authorized official

Name

Grant Norman Ko, MD

Title

Owner

Phone

(707) 800-7700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502236800000",
    "number": "1750806865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "707-800-7700",
            "fax_number": "707-800-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 FULTON RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014923",
            "telephone_number": "707-800-7700",
            "fax_number": "707-800-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT N KO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-09",
        "last_updated": "2017-08-09",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "NORMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-800-7700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G49179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Graham
• Khatiba Graismft, M.F.T
• Oloph K Granath, D.D.S.
• Mary Ann Granieri, P.T.
• Phyllis Grannis, MFT
• Emma Eliesabeth Grant-Dreher
• Nicole Grant, RN
• Naomi W. Granvold, MD
• Eva J Gratzinger, PH.D.
• Devin Graves

• Psychiatry Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; 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.