Provider Demographics
NPI:1477625747
Name:OLSEN KOHNER, MARGARET ELLEN (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ELLEN
Last Name:OLSEN KOHNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:ELLEN
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:11600 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1733
Mailing Address - Country:US
Mailing Address - Phone:310-473-0911
Mailing Address - Fax:310-473-0311
Practice Address - Street 1:11600 WILSHIRE BLVD
Practice Address - Street 2:SUITE 406
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1733
Practice Address - Country:US
Practice Address - Phone:310-473-0911
Practice Address - Fax:310-473-0311
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34601207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A35671Medicare UPIN