Organization Active NPI

Young J. Ko, MD a Medical Corp

  • Pulmonary Disease Physician
  • Lancaster, CA
National Provider Identifier
1891919700
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A39814 Issued in CA
Legal business name
YOUNG J. KO, MD A MEDICAL CORP
Practice address
44215 15TH St W Ste 303
Lancaster, CA 93534-5505
Phone
(661) 945-0723
Fax
(661) 949-5740
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Authorized official

Name
Dr. Young J Ko, M.D.NPI 1639277130
Title
Ceo
Phone
(661) 945-0724

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A39814 CA
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X A39814 CA
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X A39814 CA Primary

Addresses

Primary practice location

44215 15TH St W Ste 303
Lancaster, CA 93534-5505

Mailing address

44215 15TH St W Ste 303
Lancaster, CA 93534-5505
Phone (661) 945-0723

Other identifiers 1

IdentifierTypeStateIssuer
00A398140MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080609000494 CA Part B Supplier - Clinic/Group Practice 8325118987 Receives reassigned benefits from 1 practitioner
Practice locations: Lancaster, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0666012Young J Ko MD44215 15TH St West, Ste 303, Lancaster, CA 93534AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Locations

44215 15th St W
Ste 303
Lancaster, CA 93534
Phone (661) 945-0723

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1891919700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44215 15TH ST W STE 303",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935345505",
            "telephone_number": "661-945-0723",
            "fax_number": "661-949-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44215 15TH ST W STE 303",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935345505",
            "telephone_number": "661-945-0723",
            "fax_number": "661-949-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG J. KO, MD A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "YOUNG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "661-945-0724",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A39814",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A39814",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A39814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A398140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.