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1598726457

NPI Code Detail

MEDICARE: MR. STEVEN ELLIOT KOLKER MD

MEDICARE: MR. STEVEN ELLIOT KOLKER 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	207ZD0900X	Dermatopathology (Pathology) Physician	9780	NV
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD150612	OR
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	9780	NV
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A62898	CA

General Provider Information

NPI Number	:	1598726457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN ELLIOT KOLKER MD

Provider Business Mailing Address
First Line	:	2121 SANTA MONICA BLVD
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2303
Country	:	US
Telephone Number	:	310-829-8101
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 SANTA MONICA BLVD
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-2303
Country	:	US
Telephone Number	:	310-829-8101
Fax Number	:

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

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	03/28/2022

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Directions to “ MR. STEVEN ELLIOT KOLKER MD” Practice Location

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