Provider Demographics
NPI:1871464198
Name:KO, SAVANNAH (NMD)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:KO
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2691 E COCONINO DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-2989
Mailing Address - Country:US
Mailing Address - Phone:913-439-8586
Mailing Address - Fax:
Practice Address - Street 1:1783 FLIGHT WAY
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1838
Practice Address - Country:US
Practice Address - Phone:194-937-3343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath