Provider Demographics
NPI:1023210762
Name:COHEN, JOSEPH IRA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:IRA
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 1:5982 VIA LOMA
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4015
Mailing Address - Country:US
Mailing Address - Phone:951-369-0540
Mailing Address - Fax:951-346-3245
Practice Address - Street 1:5982 VIA LOMA
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4015
Practice Address - Country:US
Practice Address - Phone:951-369-0540
Practice Address - Fax:951-346-3245
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62190207ZF0201X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology