Provider Demographics
NPI:1689334468
Name:ZACHARY C COHEN MD APC
Entity Type:Organization
Organization Name:ZACHARY C COHEN MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:FAVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-993-2778
Mailing Address - Street 1:5395 RUFFIN RD STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1338
Mailing Address - Country:US
Mailing Address - Phone:858-571-3630
Mailing Address - Fax:858-295-3948
Practice Address - Street 1:5395 RUFFIN RD STE 204
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1338
Practice Address - Country:US
Practice Address - Phone:858-571-3630
Practice Address - Fax:858-295-3948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty