MEDICARE: MITCHELL E COHEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	G48872	CA

General Provider Information

NPI Number	:	1023002813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL E COHEN M.D.

Provider Business Mailing Address
First Line	:	2080 CENTURY PARK E
Second Line	:	SUITE 1609
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2001
Country	:	US
Telephone Number	:	310-203-8664
Fax Number	:	310-286-2184

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK E
Second Line	:	SUITE 1609
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2001
Country	:	US
Telephone Number	:	310-203-8664
Fax Number	:	310-286-2184

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	12/15/2015

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