Healthcare Provider Details

I. General information

NPI: 1770122889
Provider Name (Legal Business Name): RAMTIN COHANIM. MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12660 RIVERSIDE DR STE 300
STUDIO CITY CA
91607-3431
US

IV. Provider business mailing address

PO BOX 4259
CERRITOS CA
90703-4259
US

V. Phone/Fax

Practice location:
  • Phone: 818-623-5310
  • Fax:
Mailing address:
  • Phone: 562-407-2080
  • Fax: 562-407-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMTIN COHANIM
Title or Position: PRESIDENT
Credential: MD
Phone: 562-407-2080