Basic Information
Provider Information
NPI: 1225314818
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COHEN
FirstName: STELLA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD STE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900455631
CountryCode: US
TelephoneNumber: 3103018707
FaxNumber:  
Practice Location
Address1: 15503 VENTURA BLVD STE 340
Address2:  
City: ENCINO
State: CA
PostalCode: 914363132
CountryCode: US
TelephoneNumber: 8184618148
FaxNumber: 8184618105
Other Information
ProviderEnumerationDate: 10/26/2011
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA127496CAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0200XA127496CAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001XA127496CAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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