MEDICARE: HARVEY D. COHEN M.D., INC.

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	207R00000X	Internal Medicine Physician	A34367	CA

General Provider Information

NPI Number	:	1548488810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARVEY D. COHEN M.D., INC.

Provider Business Mailing Address
First Line	:	PO BOX 4049
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91729-4049
Country	:	US
Telephone Number	:	909-987-2528
Fax Number	:	909-987-4668

Provider Business Practice Location Address
First Line	:	8330 RED OAK ST STE 201
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-0603
Country	:	US
Telephone Number	:	909-987-2528
Fax Number	:	909-987-4668

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HARVEY D COHEN
Credential	:	M.D.
Telephone Number	:	909-987-1730

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	12/19/2022

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