MEDICARE: LOREN COHEN M.D.

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	2085R0202X	Diagnostic Radiology Physician	G27043	CA

General Provider Information

NPI Number	:	1346210101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOREN COHEN M.D.

Provider Business Mailing Address
First Line	:	5310 BUCK HILL AVE
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90621-1427
Country	:	US
Telephone Number	:	714-994-1595
Fax Number	:

Provider Business Practice Location Address
First Line	:	5310 BUCK HILL AVE
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90621-1427
Country	:	US
Telephone Number	:	714-994-1595
Fax Number	:

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	05/27/2010

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