Healthcare Provider Details

I. General information

NPI: 1306091186
Provider Name (Legal Business Name): JOSHUA COHEN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 11/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 FROST ST SUITE 408
SAN DIEGO CA
92123-2778
US

IV. Provider business mailing address

8010 FROST ST SUITE 408
SAN DIEGO CA
92123-2778
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-8111
  • Fax:
Mailing address:
  • Phone: 858-279-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA34624
License Number StateCA

VIII. Authorized Official

Name: BRISA WILSON
Title or Position: OFFICE STAFF
Credential:
Phone: 858-279-8111