Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A150541 | CA |
NPI | 1053775312 |
---|---|
Provider Name | Brandon Cohen |
First Address | Los Angeles, CA 90049-2708 |
Second Address | Beverly Hills, CA 90211-2285 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2016 |
Last Update Date | 21/08/2020 |