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General NPI Number Information
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NPI Number | 1457094799
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Entity Type | Organization
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Legal Business Name | KATIE MARKS COGAN MD INC A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 3831 HUGHES AVE STE 600A
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City | CULVER CITY
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State | CA
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Zip | 90232-6843
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Country | US
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Telephone | 424-603-4544
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Fax | 424-603-4546
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Provider Business Mailing Address
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Address Line | 2148 HILLSBORO AVE
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City | LOS ANGELES
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State | CA
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Zip | 90034-1121
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Country | US
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Telephone | 443-610-3059
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Fax |
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Authorized Official
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Title or Position | SHAREHOLDER
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Name | DR. KATIE MARKS
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Credential | MD
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Telephone | 443-610-3059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number |
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License Number State |
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