Provider Demographics
NPI:1245735257
Name:JEFFREY COHEN, O.D., INC.
Entity Type:Organization
Organization Name:JEFFREY COHEN, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-661-6553
Mailing Address - Street 1:2731 LICIA PL
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1544
Mailing Address - Country:US
Mailing Address - Phone:954-661-6553
Mailing Address - Fax:805-526-4954
Practice Address - Street 1:1555 SIMI TOWN CENTER WAY STE 575
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-0535
Practice Address - Country:US
Practice Address - Phone:805-577-0255
Practice Address - Fax:805-526-4954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14338152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty