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Organization
KHULOOD Y. COTTA M.D.
Active
Organization
KHULOOD Y. COTTA M.D.
Active
Other names
ST JUDE HEALTH CARE MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSA MARTINEZ (OFFICE ADMINISTRATOR)
(323) 773-0591
Entity
Organization
Contact information
Practice address
4946 FLORENCE AVE, BELL, CA 90201-4319
(323) 773-0591
Mailing address
4946 FLORENCE AVE, BELL, CA 90201-4319
(323) 773-0591
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A40215
CA
208600000X
Surgery Physician
A36591
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0068540
MEDICAL
CA
05
—
GR0068540
—
CA
01
—
W13749
MEDICARE
CA
Enumeration date
08/15/2007
Last updated
04/25/2011
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