MEDICARE: MARGOT COGGINS IMF

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	106H00000X	Marriage & Family Therapist	LMFT91188	CA

General Provider Information

NPI Number	:	1902189673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGOT COGGINS IMF

Provider Business Mailing Address
First Line	:	6456 HAYES DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5318
Country	:	US
Telephone Number	:	607-227-1494
Fax Number	:

Provider Business Practice Location Address
First Line	:	1935 HILLHURST AVE
Second Line	:	B
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2700
Country	:	US
Telephone Number	:	607-227-1494
Fax Number	:

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

Provider Enumeration Date	:	09/20/2011
Last Update Date	:	03/03/2017

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