Provider Demographics
NPI:1083141162
Name:COHEN, MARK AARON (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:AARON
Last Name:COHEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 377308
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96737-7308
Mailing Address - Country:US
Mailing Address - Phone:808-640-9360
Mailing Address - Fax:
Practice Address - Street 1:92-8961 #8 LOTUS BLOSSOM DR.
Practice Address - Street 2:
Practice Address - City:OCEAN VIEW
Practice Address - State:HI
Practice Address - Zip Code:96737-7308
Practice Address - Country:US
Practice Address - Phone:808-640-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC-975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor