| Kayla Koo Dds Inc | |
|
5680 Whittier Blvd Commerce CA 90022-4106 | |
| (323) 597-0000 | |
| Not Available |
| Full Name | Kayla Koo Dds Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5680 Whittier Blvd, Commerce, California |
| Authorized Official Name and Position | Kayla Koo (OWNER) |
| Authorized Official Contact | 3235970000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kayla Koo Dds Inc 5680 Whittier Blvd Commerce CA 90022-4106 Ph: (323) 597-0000 | Kayla Koo Dds Inc 5680 Whittier Blvd Commerce CA 90022-4106 Ph: (323) 597-0000 |
| NPI Number | 1174990287 |
|---|---|
| Provider Enumeration Date | 08/24/2015 |
| Last Update Date | 02/19/2023 |
| Medicare PECOS PAC ID | 7911240031 |
|---|---|
| Medicare Enrollment ID | O20190513001736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174990287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 56273 (California) | Primary |
| Provider Name | Kayla Koo |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1942495510 PECOS PAC ID: 2668787565 Enrollment ID: I20190513001986 |
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