Provider Demographics
NPI:1790984318
Name:IRA RICHARD COHEN
Entity Type:Organization
Organization Name:IRA RICHARD COHEN
Other - Org Name:BELLFLOWER DOWNEY PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:562-923-0371
Mailing Address - Street 1:10727 PARAMOUNT BLVD
Mailing Address - Street 2:SUITE#1
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3336
Mailing Address - Country:US
Mailing Address - Phone:562-923-0371
Mailing Address - Fax:562-869-8419
Practice Address - Street 1:10727 PARAMOUNT BLVD
Practice Address - Street 2:SUITE#1
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3336
Practice Address - Country:US
Practice Address - Phone:562-923-0371
Practice Address - Fax:562-869-8419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2612A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWE11788Medicare PIN