Provider Demographics
NPI:1548268352
Name:COBB, VALENCIA J (MD)
Entity type:Individual
Prefix:DR
First Name:VALENCIA
Middle Name:J
Last Name:COBB
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2101 EAST JEFFESON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:14139 POTOMAC MILLS RD
Practice Address - Street 2:KAISER PERMANENTE WOODBRIDGE MEDICAL CENTER
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4644
Practice Address - Country:US
Practice Address - Phone:703-490-7615
Practice Address - Fax:703-490-7650
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2022-02-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101237036207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190002035Medicare PIN