MEDICARE: JONATHAN F. KOHAN, MD, INC

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	174400000X	Specialist	A66353	CA

General Provider Information

NPI Number	:	1518028422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN F. KOHAN, MD, INC

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	:	818-788-2453

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	:	818-788-2453

Authorized Official
Title or Position	:	MD
Name	:	DR. JONATHAN F KOHAN
Credential	:	MD
Telephone Number	:	818-788-2400

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	10/15/2013

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