Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 20A6844 | CA |
NPI | 1073545968 |
---|---|
Provider Name | Dr. William Clay Cohen |
First Address | Orange, CA 92869-3204 |
Second Address | Orange, CA 92869 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 05/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G84183 | (02) | CA |