DR. CHARLES CHUNGMO KOO (NPI# 1356464663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356464663 |
| Entity Type | Individual |
| Full Name | DR. CHARLES CHUNGMO KOO |
| Credential | D.D.S. |
| Practice Address |
2405 W 8th St Suite 202 Los Angeles CA 90057-5016 |
| Practice Telephone | 2133858888 |
| Practice Fax Number | 2133858325 |
| Mailing Telephone | 2133858888 |
| Mailing Fax Number | 2133858325 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
B27315 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTI-CAL | B27315-01 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194001875 | Charles C Koo | Massage Therapist | 430 Sherman Ave Ste 205, Palo Alto, CA 94306-1853 | 2011-10-26 |
| 1609947597 | Charles C. Koo | Pathology | 4733 W Sunset Blvd, Los Angeles, CA 90027-6021 | 2006-11-13 |
| 1396782595 | Charles H Koo | Internal Medicine | 11 Meridian Rd, Eatontown, NJ 07724-2242 | 2006-05-31 |
| Street Address |
2405 W 8TH ST SUITE 202 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90057-5016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386689453 | Loraine Diego | Obstetrics & Gynecology | 2405 W 8th St, Suite #105, Los Angeles, CA 90057-5016 | 2006-06-20 |
| 1750793964 | Melina Herrero | Physical Therapist | 2405 W 8th St, Suite # 201, Los Angeles, CA 90057-5016 | 2014-05-21 |
| 1265668065 | Peter H. Sim, M.d., Inc. | Internal Medicine | 2405 W 8th St, Suite 105, Los Angeles, CA 90057-5016 | 2009-06-08 |
| 1700012663 | Loraine V. Digeo, M.d. Inc | Obstetrics & Gynecology | 2405 W 8th St, Suite 105, Los Angeles, CA 90057-5016 | 2009-06-05 |
| 1619111820 | Luna P Caro | Nurse Practitioner | 2405 W 8th St, Suite 105, Los Angeles, CA 90057-5016 | 2009-05-01 |
| 1487868535 | Michelle Tancio | Occupational Therapist | 2405 W 8th St, 201, Los Angeles, CA 90057-5016 | 2007-05-09 |
| 1891716353 | Won Chull Kim | Pediatrics | 2405 W 8th St, 205, Los Angeles, CA 90057-5016 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518315 | Mayulee Wilawanwelsh | Massage Therapist | 349 S Lafayette Pk Pl, Los Angeles, CA 90057 | 2020-11-03 |
| 1437714615 | Jackeline L Ramon | Social Worker | 572 S. La Fayette Park Place #6, Los Angeles, CA 90057 | 2019-05-03 |
| 1467015743 | Chanhwi Jung | Acupuncturist | 349 South Lafayette Park Place, #208, Los Angeles, CA 90057 | 2019-04-22 |
| 1356818850 | Anshim Acupuncture Inc | Acupuncturist | 4501 Alameda St., #107b #115, Los Angeles, CA 90057 | 2018-11-01 |
| 1538634670 | Karina Herrera | Case Manager/Care Coordinator | 679 S. Hampshire Ave, Los Angeles, CA 90057 | 2018-10-04 |
| 1306323506 | Jessica Myung Jin Yun | Counselor | 520 S Lafayette Park Pl, Unit 300, Los Angeles, CA 90057 | 2018-07-20 |
| 1851887012 | Scott Moon | Dentist | 2426 W. 8th St. #209, Los Angeles, CA 90057 | 2018-07-10 |
| 1780176107 | Bianca Zafiro | Case Manager/Care Coordinator | 672 S Lafayette Park Place, Suite 6, Los Angeles, CA 90057 | 2018-06-01 |
| 1639677438 | Claudia E Vides Inc A Dental Corporation | Clinic/Center | 2033 W. 7th Street, Los Angeles, CA 90057 | 2018-01-26 |
| 1720596414 | Hee Sun No | Pharmacist | 269 S Lafayette Park Pl, 210, Los Angeles, CA 90057 | 2018-01-16 |
| Find all providers in zip 90057 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295349082 | Reza Mehr | Dentist | 900 W Temple St Apt 506, Los Angeles, CA 90012-4551 | 2020-08-31 |
| 1396355590 | Kamyar Moradian | Dentist | 9201 Venice Blvd, Los Angeles, CA 90034-3324 | 2020-08-04 |
| 1669096160 | Leora H Sheily Dds PC | Dentist | 4852 Melrose Ave, Los Angeles, CA 90029-3736 | 2020-06-01 |
| 1013539535 | Smit Dangaria Dds Phd Inc | Dentist | 1325 S Harvard Blvd, Los Angeles, CA 90006-4229 | 2020-05-07 |
| 1912530585 | Sara Bahri Sabokpey | Dentist | 2001 Stradella Rd, Los Angeles, CA 90077-2322 | 2020-02-21 |
| 1518504497 | Jonathan Dye | Dentist | 1626 Palo Alto St Apt 102, Los Angeles, CA 90026-5052 | 2019-12-10 |
| 1972147940 | Catherine Margary Cuaco Begazo | Dentist | 100 S Doheny Dr Apt 209, Los Angeles, CA 90048-2926 | 2019-11-03 |
| 1386285427 | Jefferson Dental Corporation | Dentist | 12013 Wilshire Blvd, Los Angeles, CA 90025-1201 | 2019-09-30 |
| 1043868698 | Semyon Segal | Dentist | 2815 W Sunset Blvd Ste 106, Los Angeles, CA 90026-2168 | 2019-08-27 |
| 1144875592 | Jay Singh | Dentist | 11346 Iowa Ave Apt 203, Los Angeles, CA 90025-6085 | 2019-08-02 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90057 |
Please comment or provide details below to improve the information on DR. CHARLES CHUNGMO KOO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.