Provider Demographics
NPI:1750445581
Name:COHEN, FRED E (MD)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:E
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 1:345 CALIFORNIA ST
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-2606
Mailing Address - Country:US
Mailing Address - Phone:415-743-1559
Mailing Address - Fax:
Practice Address - Street 1:345 CALIFORNIA ST
Practice Address - Street 2:SUITE 3300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-2606
Practice Address - Country:US
Practice Address - Phone:415-743-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA53008Medicare UPIN