Provider Demographics
NPI:1013190248
Name:HART C.M. COHEN
Entity Type:Organization
Organization Name:HART C.M. COHEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-659-7691
Mailing Address - Street 1:8635 W 3RD ST
Mailing Address - Street 2:450W
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-6101
Mailing Address - Country:US
Mailing Address - Phone:310-652-5954
Mailing Address - Fax:310-652-7570
Practice Address - Street 1:8635 W 3RD ST
Practice Address - Street 2:450W
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6101
Practice Address - Country:US
Practice Address - Phone:310-652-5954
Practice Address - Fax:310-652-7570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63878174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14285Medicare PIN