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General NPI Number Information
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NPI Number | 1629306733
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Entity Type | Organization
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Legal Business Name | M. JOSHUA COHEN, M.D. INC.
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 12/01/2009
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Provider Practice Location Address
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Address Line | 7695 CARDINAL CT SUITE 390
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City | SAN DIEGO
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State | CA
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Zip | 92123-3357
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Country | US
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Telephone | 858-279-8111
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Fax | 858-279-4703
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Provider Business Mailing Address
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Address Line | 7695 CARDINAL CT SUITE 390
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City | SAN DIEGO
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State | CA
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Zip | 92123-3357
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Country | US
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Telephone | 858-279-8111
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Fax | 858-279-4703
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Authorized Official
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Title or Position | OWNER
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Name | DR. MANSOUR JOSHUA COHEN
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Credential | M.D.
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Telephone | 858-279-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A34624
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License Number State | CA
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