Provider Demographics
NPI:1750462750
Name:COHEN, MUSCH, THOMAS MEDICAL GROUP
Entity type:Organization
Organization Name:COHEN, MUSCH, THOMAS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYASY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-228-3366
Mailing Address - Street 1:555 E TACHEVAH DR
Mailing Address - Street 2:STE 3W101
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-5785
Mailing Address - Country:US
Mailing Address - Phone:760-361-8525
Mailing Address - Fax:760-361-8528
Practice Address - Street 1:555 E TACHEVAH DR
Practice Address - Street 2:STE 3W101
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5785
Practice Address - Country:US
Practice Address - Phone:760-361-8525
Practice Address - Fax:760-361-8528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36342208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty