Individual
IAN COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11620 WILSHIRE BLVD STE 210, LOS ANGELES, CA 90025-1262
(310) 455-6210
(310) 455-6098
Mailing address
11620 WILSHIRE BLVD STE 210, LOS ANGELES, CA 90025-1262
(310) 455-6210
(310) 455-6098
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G70565
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G705650
MEDICAL
CA
Enumeration date
08/11/2006
Last updated
12/03/2018
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