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General NPI Number Information
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NPI Number | 1922170463
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Entity Type | Individual
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Provider Name | NEVILLE STANLEY COHEN O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 613 E GRAND AVE
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City | ESCONDIDO
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State | CA
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Zip | 92025-4402
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Country | US
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Telephone | 760-743-4616
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Fax | 760-480-7393
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Provider Business Mailing Address
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Address Line | 613 E GRAND AVE
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City | ESCONDIDO
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State | CA
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Zip | 92025-4402
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Country | US
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Telephone | 760-743-4616
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Fax | 760-480-7393
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6419T
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License Number State | CA
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