Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | G44410 | CA |
NPI | 1043290455 |
---|---|
Provider Name | Stuart Cohen |
First Address | Sacramento, CA 95817-1460 |
Second Address | Sacramento, CA 95817-1460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 02/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A49641 | (02) | CA |