Individual
IVAN ALEXANDRE DE KOUCHKOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 PARNASSUS AVE, INTERNAL MEDICINE RESIDENCY PROGRAM, SAN FRANCISCO, CA 94143-2204
(415) 476-1529
Mailing address
505 PARNASSUS AVE, INTERNAL MEDICINE RESIDENCY PROGRAM, SAN FRANCISCO, CA 94143-2204
(415) 476-1529
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
A152456
CA
Other
Enumeration date
03/23/2016
Last updated
03/09/2023
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