Provider Demographics
NPI:1508187469
Name:WILLIAM B COHEN MD A MEDICAL CORP
Entity Type:Organization
Organization Name:WILLIAM B COHEN MD A MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-887-0500
Mailing Address - Street 1:149 S BARRINGTON AVE
Mailing Address - Street 2:NO. 806
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-3310
Mailing Address - Country:US
Mailing Address - Phone:310-887-0500
Mailing Address - Fax:310-889-1912
Practice Address - Street 1:8733 BEVERLY BLVD
Practice Address - Street 2:STE 310
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1827
Practice Address - Country:US
Practice Address - Phone:310-887-0500
Practice Address - Fax:310-889-1912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG205652086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty