Provider Demographics
NPI:1013443902
Name:COHEN CHIROPRACTIC INC
Entity Type:Organization
Organization Name:COHEN CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-449-0593
Mailing Address - Street 1:8781 CUYAMACA ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4216
Mailing Address - Country:US
Mailing Address - Phone:619-449-0593
Mailing Address - Fax:
Practice Address - Street 1:8781 CUYAMACA ST
Practice Address - Street 2:SUITE J
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4216
Practice Address - Country:US
Practice Address - Phone:619-449-0593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHM475AMedicare PIN