Ko Thouth, is a
Community Health Worker based in Stockton, California. Ko Thouth is licensed to practice in * (Not Available) (license number ) and his current practice location is
1212 N California St, Stockton, California. He can be reached at his office (for appointments etc.) via phone at
(209) 468-8880.
NPI number for Ko Thouth is 1356602353 and his current mailing address is 1212 N California St, Stockton, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1356602353.
Healthcare Provider's Profile
| Full Name | Ko Thouth |
|---|
| Gender | Male |
|---|
| Speciality | Community Health Worker |
|---|
| Location | 1212 N California St, Stockton, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1356602353
- Provider Enumeration Date: 06/06/2012
- Last Update Date: 12/20/2023
Medical Identifiers
Medical identifiers for Ko Thouth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356602353 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ko Thouth is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ko Thouth,
1212 N California St,
Stockton, CA 95202-1552
Ph: () - | Ko Thouth,
1212 N California St,
Stockton, CA 95202-1552
Ph: (209) 468-8880 |
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