| Victor L Kovner Md Facp | |
|
7060 Via Mariposa Sur Bonsall CA 92003-5621 | |
| (760) 643-9306 | |
| (760) 643-9399 |
| Full Name | Victor L Kovner Md Facp |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 7060 Via Mariposa Sur, Bonsall, California |
| Authorized Official Name and Position | Victor Lee Kovner (SOLE PROPRIETOR) |
| Authorized Official Contact | 7606439306 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victor L Kovner Md Facp 7060 Via Mariposa Sur Bonsall CA 92003-5621 Ph: (760) 643-9306 | Victor L Kovner Md Facp 7060 Via Mariposa Sur Bonsall CA 92003-5621 Ph: (760) 643-9306 |
| NPI Number | 1134323488 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 12/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134323488 | NPI | - | NPPES |
| 00A286660 | Medicaid | CA | |
| W15120 | Other | CA | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A28666 (California) | Primary |
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