MEDICARE: DR. CAROL KOCHOFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	23450	CA

General Provider Information

NPI Number	:	1194940932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL KOCHOFF

Provider Business Mailing Address
First Line	:	PO BOX 110
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90406-0110
Country	:	US
Telephone Number	:	310-749-2320
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 S BARRINGTON AVE
Second Line	:	SUITE 211
City	:	WEST LOS ANGELES
State	:	CA
Zip	:	90025-5363
Country	:	US
Telephone Number	:	310-749-2320
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	04/03/2008

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