Provider Demographics
NPI:1841367208
Name:COHEN, ANDREW TODD (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:TODD
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 1:201 S LASKY DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3647
Mailing Address - Country:US
Mailing Address - Phone:310-659-8771
Mailing Address - Fax:310-659-9599
Practice Address - Street 1:201 S LASKY DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3647
Practice Address - Country:US
Practice Address - Phone:310-659-8771
Practice Address - Fax:310-659-9599
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56223174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA56223OtherMEDICAL LICENSE NUMBER