MARK W. KOUKKARI M.D. NPI 1750479929

NPI Information

  • NPI: 1750479929
  • Provider Name: MARK W. KOUKKARI, M.D.
  • Classification: Psychiatry & Neurology - 2084N0402X
  • Specialization: Neurology with Special Qualifications in Child Neurology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2577 SAMARITAN DRIVE
    SUITE 725
    SAN JOSE, CA
    ZIP 95129
  • Phone: (408) 524-5700

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NPI Details

Mark W. Koukkari, M.D. is a neurology with special qualifications in child neurology psychiatry neurology in San Jose, CA with 36 years of experience. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. Mark W. Koukkari, M.D. NPI is 1750479929. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduation Year:1990

The provider's business location address is:

2577 SAMARITAN DRIVE
SUITE 725
SAN JOSE, CA
ZIP 95129-552
Phone: (408) 524-5700

The NPI 1750479929 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 3/22/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistG74711CALIFORNIANo
22084N0400XPsychiatry & NeurologyNeurologyG74711CALIFORNIANo
32084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyG74711CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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