MEDICARE: DR. GERALD COHEN D.C.

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	111NN0400X	Neurology Chiropractor	CA14343	CA

General Provider Information

NPI Number	:	1679659783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD COHEN D.C.

Provider Business Mailing Address
First Line	:	1040 NOEL DR STE 102
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-3359
Country	:	US
Telephone Number	:	650-328-4325
Fax Number	:	650-566-1584

Provider Business Practice Location Address
First Line	:	1040 NOEL DR STE 102
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-3359
Country	:	US
Telephone Number	:	650-328-4325
Fax Number	:	650-566-1584

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

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	07/08/2007

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