Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | G8016 | CA |
NPI | 1023071065 |
---|---|
Provider Name | Dr. Joseph David Cohn |
First Address | Santa Rosa, CA 95409-5886 |
Second Address | Santa Rosa, CA 95409-5886 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 28/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000G80160 | (05) | CA |
020048889 | RR MEDICARE (01) | CA |
E13153 | (02) | NJ |