Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A132816 | CA |
NPI | 1114191194 |
---|---|
Provider Name | Amit Kochhar |
First Address | Santa Monica, CA 90404-1337 |
Second Address | Los Angeles, CA 90033-5310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2008 |
Last Update Date | 03/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A132816 | MEDICAL LICENSE (01) | CA |