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Physician Compare National (NPI:1598159709)

HEALTHCARE PROVIDER: RICHARD COCKERILL 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 1598159709
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 9931480316
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20161222001002
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name COCKERILL
Individual professional last name
Provider First Name RICHARD
Individual professional first name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name MAYO MEDICAL SCHOOL
Individual professional's medical school
Graduation Year 2015
Individual professional's medical school graduation year
Primary Specialty PSYCHIATRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name SAN FERNANDO VALLEY COMMUNITY MENTAL HEALTH CENTER
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 1456332998
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 5
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 11631 VICTORY BLVD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 203
Group Practice or individual's line 2 address
City NORTH HOLLYWOOD
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 916063572
Group Practice or individual's zip code (9 digits when available)
Phone Number 8189083855
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

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