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General NPI Number Information
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NPI Number | 1194932715
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Entity Type | Organization
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Legal Business Name | GORDON R. COHEN, M.D., INC.
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1570 THE ALAMEDA #228
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City | SAN JOSE
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State | CA
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Zip | 95126-2330
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Country | US
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Telephone | 408-293-3888
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Fax | 408-293-1029
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Provider Business Mailing Address
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Address Line | 1570 THE ALAMEDA #228
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City | SAN JOSE
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State | CA
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Zip | 95126-2330
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Country | US
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Telephone | 408-293-3888
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Fax | 408-293-1029
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Authorized Official
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Title or Position | OWNER
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Name | DR. CORDON RICHARD COHEN
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Credential | M.D.
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Telephone | 408-293-3888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C25141
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License Number State | CA
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