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General NPI Number Information
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NPI Number | 1760502637
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Entity Type | Organization
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Legal Business Name | GERARD D. & EDITH T. COHEN
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 238 SOUTH ARROYO PARKWAY, SUITE 140
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City | PASADENA
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State | CA
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Zip | 91105-4190
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Country | US
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Telephone | 626-449-9000
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Fax | 626-449-9939
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Provider Business Mailing Address
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Address Line | 4550 ALTA CANYADA RD
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City | LA CANADA
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State | CA
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Zip | 91011-2028
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Country | US
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Telephone | 818-790-5090
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Fax | 818-790-5049
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. GERARD DOMINIQUE COHEN
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Credential | D.C.
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Telephone | 626-449-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14344
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License Number State | CA
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