Provider Demographics
NPI:1124047501
Name:KO, ELLEN C (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:C
Last Name:KO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:400 N PEPPER AVENUE
Mailing Address - Street 2:ARMC PATHOLOGY
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-1819
Mailing Address - Country:US
Mailing Address - Phone:909-580-0010
Mailing Address - Fax:909-580-0064
Practice Address - Street 1:400 N PEPPER AVENUE
Practice Address - Street 2:ARMC PATHOLOGY
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324
Practice Address - Country:US
Practice Address - Phone:909-580-0010
Practice Address - Fax:909-580-0064
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-03-13
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Provider Licenses
StateLicense IDTaxonomies
CAG78277207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology