Individual
SHANNON KOGACHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 453-1324
(424) 212-5921
Mailing address
8700 BEVERLY BLVD, SUITE 5512, LOS ANGELES, CA 90048
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A165617
CA
208M00000X
Hospitalist Physician
Primary
A165617
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2018
Last updated
02/16/2024
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