Provider Demographics
NPI:1770785073
Name:EROL KOSAR MD INC
Entity type:Organization
Organization Name:EROL KOSAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOSAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-792-5800
Mailing Address - Street 1:4201 TORRANCE BLVD
Mailing Address - Street 2:SUITE 560
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4504
Mailing Address - Country:US
Mailing Address - Phone:310-792-5800
Mailing Address - Fax:310-792-5801
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:SUITE 560
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4504
Practice Address - Country:US
Practice Address - Phone:310-792-5800
Practice Address - Fax:310-792-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75877207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19504OtherMEDICARE ID GROUP PROV #
CAWG75877EOtherMEDICARE ID
CA00G758770Medicaid
CA1104820927OtherINDIVIDUAL NPI NUMBER
CAE96595Medicare UPIN