Provider Demographics
NPI:1508893223
Name:COHEN, HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:COHEN
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 1:175 LENNON LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2485
Mailing Address - Country:US
Mailing Address - Phone:925-296-7156
Mailing Address - Fax:925-296-7174
Practice Address - Street 1:1601 YGNACIO VALLEY RD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3122
Practice Address - Country:US
Practice Address - Phone:925-296-7156
Practice Address - Fax:925-296-7174
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG310762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300082409Medicare PIN
CA00G310767Medicare PIN
CA00G310764Medicare PIN
CA00G310765Medicare PIN
CA00G310769Medicare PIN
CA300097025Medicare PIN
CAA89502Medicare UPIN
CA00G310766Medicare PIN
CA00G310761Medicare PIN
CA00G310768Medicare PIN
CA300104426Medicare PIN
CA00G310763Medicare PIN
CA300039419Medicare PIN
CA00G310760Medicare PIN