Individual
MARK W. KOUKKARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2577 SAMARITAN DRIVE, SUITE 725, SAN JOSE, CA 95129-4552
(408) 524-5700
Mailing address
2350 W EL CAMINO REAL, 2ND FLOOR, MOUNTAIN VIEW, CA 94040-6201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G74711
CA
2084N0400X
Neurology Physician
G74711
CA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
G74711
CA
Other
Enumeration date
10/11/2006
Last updated
03/22/2016
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