Provider Demographics
NPI:1548268873
Name:KO, WILLIAM WENG PING (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:WENG PING
Last Name:KO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:117 S MISSION DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1101
Mailing Address - Country:US
Mailing Address - Phone:626-284-2168
Mailing Address - Fax:626-284-7980
Practice Address - Street 1:117 S MISSION DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1101
Practice Address - Country:US
Practice Address - Phone:626-284-2168
Practice Address - Fax:626-284-7980
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2008-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG73648207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G736480Medicaid
CAG73648OtherSTATE LICENSE NUMBER
CAF31379Medicare UPIN