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General NPI Number Information
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NPI Number | 1831204494
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Entity Type | Organization
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Legal Business Name | GARY A COHEN MD INC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | STE J 9833 PACIFIC HEIGHTS BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92121-4707
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Country | US
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Telephone | 858-458-0940
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Fax | 858-458-3688
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Provider Business Mailing Address
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Address Line | 9833 PACIFIC HEIGHTS BLVD SUITE J
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City | SAN DIEGO
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State | CA
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Zip | 92121-4707
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Country | US
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Telephone | 858-458-0940
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Fax | 858-458-3688
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. GARY ALAN COHEN
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Credential | MD
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Telephone | 858-458-0940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | G43070
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License Number State | CA
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