Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 23943 | CA |
NPI | 1053725416 |
---|---|
Provider Name | Cynthia Cohan |
First Address | Los Altos, CA 94024-5555 |
Second Address | San Mateo, CA 94402-2514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2014 |
Last Update Date | 13/06/2014 |