Healthcare Provider Details

I. General information

NPI: 1689200594
Provider Name (Legal Business Name): GREG G KOJAYAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

757 WESTWOOD PLZ
LOS ANGELES CA
90095-7419
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-5841
  • Fax:
Mailing address:
  • Phone: 310-267-8654
  • Fax: 310-267-3766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA190679
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: