Provider Demographics
NPI:1881993061
Name:COHEN, DAVID JEROME (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JEROME
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 1:13280 EVENING CREEK DR S STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4109
Mailing Address - Country:US
Mailing Address - Phone:858-546-3800
Mailing Address - Fax:
Practice Address - Street 1:13280 EVENING CREEK DR S STE 110
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4109
Practice Address - Country:US
Practice Address - Phone:858-546-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-27
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2912802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology