Provider Demographics
NPI:1710353966
Name:DAMON COBB DO INCORPORATED
Entity type:Organization
Organization Name:DAMON COBB DO INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-245-9030
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 1:7901 FROST ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2701
Practice Address - Country:US
Practice Address - Phone:589-394-8888
Practice Address - Fax:858-303-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11368207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty