Provider Demographics
NPI:1073545968
Name:COHEN, WILLIAM CLAY (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CLAY
Last Name:COHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W LA VETA AVE STE 445
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4306
Mailing Address - Country:US
Mailing Address - Phone:714-628-1313
Mailing Address - Fax:714-628-1319
Practice Address - Street 1:1010 W LA VETA AVE STE 445
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4306
Practice Address - Country:US
Practice Address - Phone:714-628-1313
Practice Address - Fax:714-628-1319
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6844207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG84183Medicare UPIN
CAW18531Medicare ID - Type UnspecifiedMEDICARE ID #