Provider Demographics
NPI:1891746665
Name:KOGA, CLAIRE H (MD)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:H
Last Name:KOGA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5823 YORK BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-2634
Mailing Address - Country:US
Mailing Address - Phone:323-255-5643
Mailing Address - Fax:323-254-2158
Practice Address - Street 1:1701 E CESAR CHAVEZ AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2464
Practice Address - Country:US
Practice Address - Phone:323-226-1100
Practice Address - Fax:323-226-1101
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2021-12-01
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Provider Licenses
StateLicense IDTaxonomies
CAG46669207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G466690OtherBLUE SHIELD
GA080052217OtherMEDICARE RAILROAD
CA00G466690Medicaid
CA00G466690OtherBLUE SHIELD