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General NPI Number Information
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NPI Number | 1508187469
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Entity Type | Organization
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Legal Business Name | WILLIAM B COHEN MD A MEDICAL CORP
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Dates
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Enumeration Date | 06/15/2010
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 8733 BEVERLY BLVD STE 310
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1827
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Country | US
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Telephone | 310-887-0500
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Fax | 310-889-1912
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Provider Business Mailing Address
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Address Line | 149 S BARRINGTON AVE NO. 806
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City | LOS ANGELES
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State | CA
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Zip | 90049-3310
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Country | US
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Telephone | 310-887-0500
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Fax | 310-889-1912
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Authorized Official
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Title or Position | MD, PRESIDENT
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Name | WILLIAM B COHEN
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Credential | MD
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Telephone | 310-887-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | G20565
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License Number State | CA
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