Provider Demographics
NPI:1750398509
Name:BARCOHANA, DAVID (MD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:BARCOHANA
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:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213-0355
Mailing Address - Country:US
Mailing Address - Phone:310-276-6933
Mailing Address - Fax:310-271-0980
Practice Address - Street 1:8929 WILSHIRE BLVD
Practice Address - Street 2:SUITE 225
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1938
Practice Address - Country:US
Practice Address - Phone:310-276-6933
Practice Address - Fax:310-271-0980
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38962207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0046420Medicaid
CAHH434ZMedicare PIN
CAA28776Medicare UPIN