Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | A60375 | CA |
Y | 208200000X | Surgeon | A60375 | CA |
Y | 208600000X | Surgeon | A60375 | CA |
NPI | 1770627259 |
---|---|
Provider Name | Dr. Daniel Kosoy |
First Address | San Diego, CA 92131-2510 |
Second Address | San Diego, CA 92123-2701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 24/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
867378 | (02) | CA |
CE226Y | MEDICARE PTAN (BALBOA NEPHROLOGY MEDICAL GROUP) (01) | CA |