Basic Information
| Provider Information | |||||||||
| NPI: | 1295016475 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KO | ||||||||
| FirstName: | BRYCE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 51351 | ||||||||
| Address2: | |||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926191351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105979146 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11500 BROOKSHIRE AVE | ||||||||
| Address2: | PIH HEALTH DOWNEY - DEPARTMENT OF EMERGENCY MEDICINE | ||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902414917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629045000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2011 | ||||||||
| LastUpdateDate: | 12/30/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A111956 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.