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General NPI Number Information
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NPI Number | 1477628634
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Entity Type | Individual
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Provider Name | STEVEN EDWARD KOSSMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5555 RESERVOIR DR STE 306
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City | SAN DIEGO
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State | CA
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Zip | 92120-5178
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Country | US
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Telephone | 619-287-9910
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Fax | 619-287-3526
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Provider Business Mailing Address
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Address Line | 3075 HEALTH CENTER DRIVE SUITE 102
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City | SAN DIEGO
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State | CA
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Zip | 92123-2773
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Country | US
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Telephone | 619-637-7888
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Fax | 619-637-7887
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | G85236
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License Number State | CA
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