MEDICARE: RAMTIN COHANIM. 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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1770122889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAMTIN COHANIM. MD, INC

Provider Business Mailing Address
First Line	:	PO BOX 4259
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-4259
Country	:	US
Telephone Number	:	562-407-2080
Fax Number	:	562-407-2082

Provider Business Practice Location Address
First Line	:	12660 RIVERSIDE DR STE 300
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91607-3431
Country	:	US
Telephone Number	:	818-623-5310
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAMTIN COHANIM
Credential	:	MD
Telephone Number	:	562-407-2080

Provider Enumeration Date	:	01/06/2020
Last Update Date	:	01/06/2020

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