Provider Demographics
NPI:1235100603
Name:COKGOR, ILKCAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ILKCAN
Middle Name:
Last Name:COKGOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 618
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-0618
Mailing Address - Country:US
Mailing Address - Phone:415-493-3350
Mailing Address - Fax:415-493-3301
Practice Address - Street 1:1350 S ELISEO DR
Practice Address - Street 2:#220
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2011
Practice Address - Country:US
Practice Address - Phone:415-925-3590
Practice Address - Fax:415-925-8851
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA710572084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG68596Medicare UPIN