Provider Demographics
NPI:1144215419
Name:SOHN, CALVIN COOLIDGE (DC)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:COOLIDGE
Last Name:SOHN
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 1:4360 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4722
Mailing Address - Country:US
Mailing Address - Phone:310-398-2727
Mailing Address - Fax:310-572-7910
Practice Address - Street 1:4360 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4722
Practice Address - Country:US
Practice Address - Phone:310-398-2727
Practice Address - Fax:310-572-7910
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0113800Medicaid
CADC11380Medicare ID - Type Unspecified
CADC0113800Medicaid