Physician Compare National (NPI:1184790305)

HEALTHCARE PROVIDER: MARIO KOHAN MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1184790305
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850420605
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100603000660
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KOHAN
	Individual professional last name
Provider First Name	MARIO
	Individual professional first name
Provider Middle Name	ABEL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LOS ANGELES CLINICA MEDICA GENERAL MEDICAL CENTER, INC.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1254324742
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	14
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2208 W 7TH ST
	Group Practice or individual's line 1 address
City	LOS ANGELES
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	900574002
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2133843434
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y