Provider Demographics
NPI:1427204478
Name:BOCKOFF, DAVID B (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:BOCKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 69507
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-0507
Mailing Address - Country:US
Mailing Address - Phone:310-652-5800
Mailing Address - Fax:323-654-6990
Practice Address - Street 1:8500 WILSHIRE BLVD STE 926
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3107
Practice Address - Country:US
Practice Address - Phone:310-652-5800
Practice Address - Fax:323-654-6990
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC31290208VP0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A34516Medicare UPIN