Organization
MALCOLM COSGROVE, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALCOLM DAVID COSGROVE MD (PRESIDENT)
(818) 906-0635
Entity
Organization
Contact information
Practice address
16311 VENTURA BLVD, STE 800, ENCINO, CA 91436-2124
(818) 906-0635
(818) 906-7303
Mailing address
16311 VENTURA BLVD, STE 800, ENCINO, CA 91436-2124
(818) 906-0635
(818) 906-7303
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A25183
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A251830
—
CA
01
—
208800000X
TAXONOMIES
CA
01
—
340006193
RAILROAD MEDICARE
CA
Enumeration date
01/22/2007
Last updated
11/07/2014
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