Healthcare Provider Details

I. General information

NPI: 1730359589
Provider Name (Legal Business Name): CHRISTINE ANN COHN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2008
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 AIRWAY AVE STE U3
COSTA MESA CA
92626-4627
US

IV. Provider business mailing address

3151 AIRWAY AVE STE U3
COSTA MESA CA
92626-4627
US

V. Phone/Fax

Practice location:
  • Phone: 714-754-8008
  • Fax: 714-754-8007
Mailing address:
  • Phone: 714-754-8008
  • Fax: 714-754-8007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number24840
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: