Healthcare Provider Details

I. General information

NPI: 1659498814
Provider Name (Legal Business Name): DAVID I COHEN M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 TORRANCE BLVD STE A
TORRANCE CA
90503-5800
US

IV. Provider business mailing address

3475 TORRANCE BLVD STE A
TORRANCE CA
90503-5800
US

V. Phone/Fax

Practice location:
  • Phone: 310-370-3568
  • Fax: 310-316-9188
Mailing address:
  • Phone: 310-370-3568
  • Fax: 310-316-9188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG70286
License Number StateCA

VIII. Authorized Official

Name: DAVID I COHEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-370-3568