MEDICARE: JONATHAN F KOHAN 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	207L00000X	Anesthesiology Physician	A66353	CA

General Provider Information

NPI Number	:	1093727109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN F KOHAN MD

Provider Business Mailing Address
First Line	:	5651 SEPULVEDA BLVD
Second Line	:	SUITE 201
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91411-2916
Country	:	US
Telephone Number	:	818-788-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	5651 SEPULVEDA BLVD
Second Line	:	SUITE 201
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91411-2916
Country	:	US
Telephone Number	:	818-788-2400
Fax Number	:

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

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	08/14/2015

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