MEDICARE: MR. DANIEL J COHEN CRNA

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	367500000X	Certified Registered Nurse Anesthetist		IL

General Provider Information

NPI Number	:	1073533949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL J COHEN CRNA

Provider Business Mailing Address
First Line	:	PO BOX 696
Second Line	:
City	:	FAIRFAX
State	:	CA
Zip	:	94978-0696
Country	:	US
Telephone Number	:	773-793-3745
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 GEARY BLVD
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-3358
Country	:	US
Telephone Number	:	773-793-3745
Fax Number	:

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	02/11/2022

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