MEDICARE: DR. NATHAN ELLIOT COHEN DC

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	111N00000X	Chiropractor	DC13985	CA

General Provider Information

NPI Number	:	1417172255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN ELLIOT COHEN DC

Provider Business Mailing Address
First Line	:	PO BOX 788
Second Line	:
City	:	CARNELIAN BAY
State	:	CA
Zip	:	96140-0788
Country	:	US
Telephone Number	:	530-583-1609
Fax Number	:

Provider Business Practice Location Address
First Line	:	3190 FABIAN WAY,
Second Line	:	SUITE B
City	:	CARNELIAN BAY
State	:	CA
Zip	:	96140-0788
Country	:	US
Telephone Number	:	530-583-1609
Fax Number	:

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/19/2011

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