MEDICARE: AMIT KOCHHAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	A132816	CA
2	207YS0123X	Facial Plastic Surgery Physician	A136819	CA
3	390200000X	Student in an Organized Health Care Education/Training Program
4	207YS0123X	Facial Plastic Surgery Physician	A132816	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A132816	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1114191194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIT KOCHHAR MD

Provider Business Mailing Address
First Line	:	2125 ARIZONA AVE
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-1337
Country	:	US
Telephone Number	:	310-477-5558
Fax Number	:	310-477-7281

Provider Business Practice Location Address
First Line	:	11645 WILSHIRE BLVD STE 600
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6807
Country	:	US
Telephone Number	:	310-477-5558
Fax Number	:	310-477-7281

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2008
Last Update Date	:	03/29/2024

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Directions to “ AMIT KOCHHAR MD” Practice Location

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