Provider Demographics
NPI:1437149242
Name:COHANSHOHET, KAMYAR (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMYAR
Middle Name:
Last Name:COHANSHOHET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9730 WILSHIRE BLVD
Mailing Address - Street 2:STE. 202
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212
Mailing Address - Country:US
Mailing Address - Phone:310-278-1222
Mailing Address - Fax:310-278-2722
Practice Address - Street 1:9730 WILSHIRE BLVD
Practice Address - Street 2:STE. 202
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212
Practice Address - Country:US
Practice Address - Phone:310-278-1222
Practice Address - Fax:310-278-2722
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86830208VP0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI40688Medicare UPIN
CAWA86830AMedicare ID - Type Unspecified