Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | GFE13992 | CA |
NPI | 1003241878 |
---|---|
Provider Name | Stephen Norris Cohen |
First Address | San Francisco, CA 94116-1443 |
Second Address | San Francisco, CA 94116-1443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2013 |
Last Update Date | 11/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A39142 | (02) | CA |