Provider Demographics
NPI:1518028422
Name:JONATHAN F. KOHAN, MD, INC
Entity Type:Organization
Organization Name:JONATHAN F. KOHAN, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:KOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-788-2400
Mailing Address - Street 1:5651 SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2916
Mailing Address - Country:US
Mailing Address - Phone:818-788-2400
Mailing Address - Fax:818-788-2453
Practice Address - Street 1:5651 SEPULVEDA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91411-2916
Practice Address - Country:US
Practice Address - Phone:818-788-2400
Practice Address - Fax:818-788-2453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66353174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty