MEDICARE: DR. HARVEY DONALD COHEN 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	207R00000X	Internal Medicine Physician	A34367	CA
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	A34367	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972517423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARVEY DONALD COHEN MD

Provider Business Mailing Address
First Line	:	840 TOWNE CENTER DR
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-5900
Country	:	US
Telephone Number	:	909-987-2528
Fax Number	:	909-398-1488

Provider Business Practice Location Address
First Line	:	8330 RED OAK ST STE 201
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-0603
Country	:	US
Telephone Number	:	909-987-2528
Fax Number	:	909-987-4668

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	12/19/2022

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