Provider Demographics
NPI:1700611910
Name:PEDRAM KOHAN MD INC
Entity type:Organization
Organization Name:PEDRAM KOHAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-935-8367
Mailing Address - Street 1:3831 HUGHES AVE STE 604
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-6848
Mailing Address - Country:US
Mailing Address - Phone:310-935-8367
Mailing Address - Fax:
Practice Address - Street 1:3831 HUGHES AVE STE 604
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6848
Practice Address - Country:US
Practice Address - Phone:310-935-8367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty