Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E2612 | CA |
NPI | 1033207915 |
---|---|
Provider Name | Dr. Ira Richard Cohen |
First Address | Downey, CA 90240-3853 |
Second Address | Downey, CA 90240-3853 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 28/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E26120 | (05) | CA |
T11402 | (02) | CA |