Provider Demographics
NPI:1851435598
Name:COBB, DAMON CHRISTOPHER (DO)
Entity type:Individual
Prefix:
First Name:DAMON
Middle Name:CHRISTOPHER
Last Name:COBB
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 FROST ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2701
Mailing Address - Country:US
Mailing Address - Phone:858-939-4888
Mailing Address - Fax:858-303-9192
Practice Address - Street 1:3075 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2773
Practice Address - Country:US
Practice Address - Phone:858-939-4888
Practice Address - Fax:858-303-9192
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003281A207V00000X
CA20A11368207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200930660Medicaid
IN000000603951OtherANTHEM
IN200829650ROtherMEDICAID GROUP
IN200965430AOtherMEDICAID GROUP-TELL CITY
IN200829650SOtherMEDICAID GROUP-VINCENNES
KY7100071220Medicaid
IN000000603951OtherANTHEM