Healthcare Provider Details

I. General information

NPI: 1518633494
Provider Name (Legal Business Name): COHEN, CHEN, HANNA CHIROPRACTIC AND ACUPUNCTURE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

968 N GRAND AVE
COVINA CA
91724-2045
US

IV. Provider business mailing address

968 N GRAND AVE
COVINA CA
91724-2045
US

V. Phone/Fax

Practice location:
  • Phone: 626-838-3868
  • Fax: 714-839-8145
Mailing address:
  • Phone: 626-838-3868
  • Fax: 714-839-8145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. JORDAN BERNARD COHEN
Title or Position: CEO
Credential: DC
Phone: 626-838-3868