MEDICARE: DR. JOSEPH DAVID COHN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	G8016	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020048889	OTHER	CA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023071065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH DAVID COHN MD

Provider Business Mailing Address
First Line	:	6552 PINE VALLEY DR
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95409-5886
Country	:	US
Telephone Number	:	707-480-8702
Fax Number	:	707-578-6701

Provider Business Practice Location Address
First Line	:	6552 PINE VALLEY DR
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95409-5886
Country	:	US
Telephone Number	:	707-480-8702
Fax Number	:	707-578-6701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	12/28/2020

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