Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | E1610 | CA |
N | 213ES0000X | Sports Medicine | E1610 | CA |
Y | 213ES0103X | Foot & Ankle Surgery | E1610 | CA |
NPI | 1164515623 |
---|---|
Provider Name | Irwin D Cohen |
First Address | Half Moon Bay, CA 94019-1719 |
Second Address | Half Moon Bay, CA 94019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 17/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T11007 | (02) | CA |