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General NPI Number Information
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NPI Number | 1740438621
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Entity Type | Organization
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Legal Business Name | JIM COSKUN MD PC
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 750 MEDICAL CENTER CT SUITE 13
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City | CHULA VISTA
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State | CA
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Zip | 91911-6634
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Country | US
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Telephone | 619-421-6741
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Fax |
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Provider Business Mailing Address
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Address Line | 750 MEDICAL CENTER CT SUITE 13
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City | CHULA VISTA
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State | CA
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Zip | 91911-6634
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Country | US
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Telephone | 619-421-6741
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DERYA JIM COSKUN
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Credential | M.D.
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Telephone | 619-421-6741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | C53206
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License Number State | CA
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