Healthcare Provider Details
I. General information
NPI: 1770785073
Provider Name (Legal Business Name): EROL KOSAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/31/2007
Last Update Date: 03/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4201 TORRANCE BLVD SUITE 560
TORRANCE CA
90503-4504
US
IV. Provider business mailing address
4201 TORRANCE BLVD SUITE 560
TORRANCE CA
90503-4504
US
V. Phone/Fax
- Phone: 310-792-5800
- Fax: 310-792-5801
- Phone: 310-792-5800
- Fax: 310-792-5801
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | G75877 |
| License Number State | CA |
VIII. Authorized Official
Name:
EROL
M.
KOSAR
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 310-792-5800