Healthcare Provider Details

I. General information

NPI: 1104820927
Provider Name (Legal Business Name): EROL M KOSAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date: 03/15/2006
Reactivation Date: 03/23/2006

III. Provider practice location address

2841 LOMITA BLVD SUITE 100
TORRANCE CA
90505-5116
US

IV. Provider business mailing address

2481 LOMITA BLVD. SUITE 100
TORRANCE CA
90505-5116
US

V. Phone/Fax

Practice location:
  • Phone: 310-257-0508
  • Fax: 310-325-8109
Mailing address:
  • Phone: 310-257-0508
  • Fax: 310-325-8109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberG75877
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: