Provider Demographics
NPI:1134162670
Name:COHEN, ALAN M (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:M
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 1:515 E COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-2020
Mailing Address - Country:US
Mailing Address - Phone:714-871-7118
Mailing Address - Fax:714-871-3372
Practice Address - Street 1:515 E COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-2020
Practice Address - Country:US
Practice Address - Phone:714-871-7118
Practice Address - Fax:714-871-3372
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ81792085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132524301OtherCSHCN
TX82346ROtherBCBS
TX132524306Medicaid
TX82346ROtherBCBS
F04865Medicare UPIN
TX132524306Medicaid