Provider Demographics
NPI:1275266710
Name:KOSHKI, MONICA (PA-C)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:KOSHKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 HUGHES AVE STE 705
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-6838
Mailing Address - Country:US
Mailing Address - Phone:323-874-1200
Mailing Address - Fax:
Practice Address - Street 1:3831 HUGHES AVE STE 705
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6838
Practice Address - Country:US
Practice Address - Phone:323-874-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant