Provider Demographics
NPI:1811946205
Name:KOCHHAR, STEPHANIE C (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:C
Last Name:KOCHHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:15195 NATIONAL AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2631
Mailing Address - Country:US
Mailing Address - Phone:408-358-9917
Mailing Address - Fax:408-358-9927
Practice Address - Street 1:15195 NATIONAL AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2631
Practice Address - Country:US
Practice Address - Phone:408-358-9917
Practice Address - Fax:408-358-9927
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71261207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A712610Medicaid
00A712610Medicare ID - Type Unspecified
H01856Medicare UPIN