MEDICARE: MRS. MARGARET ELLEN OLSEN KOHNER MD

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	207N00000X	Dermatology Physician	C34601	CA

General Provider Information

NPI Number	:	1477625747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGARET ELLEN OLSEN KOHNER MD

Provider Business Mailing Address
First Line	:	11600 WILSHIRE BLVD
Second Line	:	SUITE 406
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1733
Country	:	US
Telephone Number	:	310-473-0911
Fax Number	:	310-473-0311

Provider Business Practice Location Address
First Line	:	11600 WILSHIRE BLVD
Second Line	:	SUITE 406
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1733
Country	:	US
Telephone Number	:	310-473-0911
Fax Number	:	310-473-0311

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/08/2007

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