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Organization

JAMIE COHEN, O.D., INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMIE COHEN (OPTOMETRIST/PRESIDENT)
(818) 889-8200
Entity
Organization

Contact information

Practice address
30740 RUSSELL RANCH RD, WESTLAKE VILLAGE, CA 91362-6399
(818) 889-8200
Mailing address
2731 LICIA PL, SIMI VALLEY, CA 93065-1544
(818) 889-8200

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14243
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FR450A
MEDICARE NUMBER
CA
Enumeration date
07/17/2014
Last updated
07/17/2014
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