Provider Demographics
NPI:1770762767
Name:BEN KOHN MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:BEN KOHN MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-454-0606
Mailing Address - Street 1:222 SURFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2911
Mailing Address - Country:US
Mailing Address - Phone:310-454-0606
Mailing Address - Fax:310-459-7763
Practice Address - Street 1:222 SURFVIEW DR
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-2911
Practice Address - Country:US
Practice Address - Phone:310-454-0606
Practice Address - Fax:310-459-7763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty