Provider Demographics
NPI:1962454041
Name:COHLER, CHERYL MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:MICHELLE
Last Name:COHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 LYNN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-1901
Mailing Address - Country:US
Mailing Address - Phone:805-495-1066
Mailing Address - Fax:805-497-1428
Practice Address - Street 1:2230 LYNN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1901
Practice Address - Country:US
Practice Address - Phone:805-495-1066
Practice Address - Fax:805-497-1428
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA78697AMedicare ID - Type Unspecified
CAI13354Medicare UPIN