| Grant N Ko Md Pc | |
|
1287 Fulton Rd Santa Rosa CA 95401-4923 | |
| (707) 800-7700 | |
| (707) 800-7799 |
| Full Name | Grant N Ko Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1287 Fulton Rd, Santa Rosa, California |
| Authorized Official Name and Position | Grant Norman Ko (OWNER) |
| Authorized Official Contact | 7078007700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant N Ko Md Pc Po Box 1770 La Mesa CA 91944-1770 Ph: (707) 800-7700 | Grant N Ko Md Pc 1287 Fulton Rd Santa Rosa CA 95401-4923 Ph: (707) 800-7700 |
| NPI Number | 1750806865 |
|---|---|
| Provider Enumeration Date | 08/09/2017 |
| Last Update Date | 08/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750806865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G49179 (California) | Primary |
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