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NPI Code Detail

MEDICARE: DR. RODNEY LAMONT COBB D.D.S.

MEDICARE: DR. RODNEY LAMONT COBB D.D.S.
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
11223G0001XGeneral Practice Dentistry38978CA

General Provider Information

NPI Number : 1588732218
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RODNEY LAMONT COBB D.D.S.
Provider Business Mailing Address
First Line : 818 W ALONDRA BLVD
Second Line :
City : COMPTON
State : CA
Zip : 90220-3500
Country : US
Telephone Number : 310-632-2113
Fax Number : 310-632-0047
Provider Business Practice Location Address
First Line : 808 W 58TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90037-3632
Country : US
Telephone Number : 323-541-1600
Fax Number : 323-541-1499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 05/04/2017

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