Provider Demographics
NPI:1841804572
Name:SHARIAR COHEN MD CORP
Entity Type:Organization
Organization Name:SHARIAR COHEN MD CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARIAR
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN-GADOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-449-8781
Mailing Address - Street 1:566 SAINT CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-3953
Mailing Address - Country:US
Mailing Address - Phone:805-449-8781
Mailing Address - Fax:805-449-4224
Practice Address - Street 1:566 SAINT CHARLES DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-3953
Practice Address - Country:US
Practice Address - Phone:805-449-8781
Practice Address - Fax:805-449-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty