Provider Demographics
NPI:1730273764
Name:COHEN, DAVID IRA (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:IRA
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 LOMITA BLVD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5116
Mailing Address - Country:US
Mailing Address - Phone:310-517-8950
Mailing Address - Fax:310-326-6080
Practice Address - Street 1:6320 N LA CHOLLA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3552
Practice Address - Country:US
Practice Address - Phone:520-545-0953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70286207RC0000X, 207RI0011X
TXS7626207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F11322Medicare UPIN