John J Koo Md Inc | |
640 Ulukahiki St Kailua HI 96734-4454 | |
(808) 263-5500 | |
Not Available |
Full Name | John J Koo Md Inc |
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Speciality | Internal Medicine |
Location | 640 Ulukahiki St, Kailua, Hawaii |
Authorized Official Name and Position | John J Koo (OWNER) |
Authorized Official Contact | 8083521981 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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John J Koo Md Inc Po Box 25490 Honolulu HI 96825-0490 Ph: (808) 536-0300 | John J Koo Md Inc 640 Ulukahiki St Kailua HI 96734-4454 Ph: (808) 263-5500 |
NPI Number | 1275826307 |
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Provider Enumeration Date | 05/23/2011 |
Last Update Date | 05/23/2011 |
Medicare PECOS PAC ID | 7517135304 |
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Medicare Enrollment ID | O20110721000725 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275826307 | NPI | - | NPPES |
591041 | Medicaid | HI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD-14092 (Hawaii) | Primary |
208M00000X | Hospitalist | MD-14092 (Hawaii) | Secondary |
Provider Name | John J Koo |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477617561 PECOS PAC ID: 8325141617 Enrollment ID: I20070306000631 |
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