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General NPI Number Information
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NPI Number | 1447239090
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Entity Type | Individual
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Provider Name | ROBERT L KOGAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 12401 WASHINGTON BLVD
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City | WHITTIER
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State | CA
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Zip | 90602-1006
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Country | US
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Telephone | 310-472-0659
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Fax | 424-208-3177
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Provider Business Mailing Address
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Address Line | PO BOX 3129
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City | TORRANCE
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State | CA
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Zip | 90510-3129
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 38422-020
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G63330
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License Number State | CA
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