Individual
HARTLEY COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
637 LUCAS AVE STE 101, LOS ANGELES, CA 90017-1997
(213) 977-1010
Mailing address
15581 WILD PLUM CIR, HUNTINGTON BEACH, CA 92647-2954
(213) 977-1010
(213) 977-1239
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A31532
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A315320
BLUE SHIELD PIN
CA
05
—
00A315320
—
CA
01
—
CB209349
MEDICARE
CA
Enumeration date
07/29/2005
Last updated
07/09/2020
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