Provider Demographics
NPI:1841435526
Name:COGGINS AND LEVY MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:COGGINS AND LEVY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DWAIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:COGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-369-7500
Mailing Address - Street 1:15559 UNION AVE
Mailing Address - Street 2:SUITE #130
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3904
Mailing Address - Country:US
Mailing Address - Phone:408-369-7500
Mailing Address - Fax:
Practice Address - Street 1:15559 UNION AVE
Practice Address - Street 2:#130
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3904
Practice Address - Country:US
Practice Address - Phone:408-879-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61490207RC0001X
CAG58266207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A614900Medicare PIN
CA00G582661Medicare PIN