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Organization

VICTOR L KOVNER MD FACP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VICTOR LEE KOVNER MD (SOLE PROPRIETOR)
(760) 643-9306
Entity
Organization

Contact information

Practice address
7060 VIA MARIPOSA SUR, BONSALL, CA 92003-5621
(760) 643-9306
(760) 643-9399
Mailing address
7060 VIA MARIPOSA SUR, BONSALL, CA 92003-5621
(760) 643-9306
(760) 643-9399

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A28666
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A286660
CA
01
W15120
PTAN
CA
Enumeration date
06/12/2007
Last updated
12/27/2007
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