Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Je Deuk Ko, MDPHD

Individual provider Child & Adolescent Psychiatry Physician · NPI 1356792758

Dr. Je Deuk Ko, MDPHD is a Psychiatry in Los Angeles, California. Graduated from Saint Louis University School of Medicine in 2016, 10 years ago. Practices with Baystate Medical Practices Inc, a 1,346-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California, Massachusetts and Missouri.

Years since qualifying
10
Trained at
Saint Louis University School of Medicine
Licensed in
CA, MA, MO
In the registry since
2016
Specialties on file
5

Practice location Address checks out

10921 Wilshire Blvd Ste 409B
Los Angeles, CA 90024-4001
Phone: (310) 922-0584
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 179040 (CA)
Child & Adolescent Psychiatry Physician Taxonomy 2084P0804X · Licence 278739 (MA)
Child & Adolescent Psychiatry Physician Taxonomy 2084P0804X · Licence A179040 (CA)
Psychiatry Physician Taxonomy 2084P0800X · Licence 278739 (MA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 2016021108 (MO)

Record details

NPI number1356792758
Entity typeIndividual (Type 1)
GenderMale
Credentials MDPHD
Sole proprietorNo
NPI enumeratedJune 27, 2016
Last updated in NPPESJuly 30, 2025
Certification dateJuly 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolSAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Baystate Medical Practices Inc — 1346 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Los Angeles