DR. EDDIE COHEN (NPI# 1538189113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538189113 |
| Entity Type | Individual |
| Full Name | DR. EDDIE COHEN |
| Credential | M.D. |
| Practice Address |
15025 Innovation Dr San Diego CA 92128-3409 |
| Mailing Address |
54433 File Los Angeles CA 90074-0001 |
| Practice Telephone | 8586057967 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2009-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | A29414 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A294140 | 05 |
| Street Address |
15025 INNOVATION DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128-3409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649240722 | Mark Edward Gallegos | Physician Assistant | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-01-23 |
| 1891896569 | Mark B. Kuhse | Emergency Medicine | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-09-26 |
| 1962504431 | Ronald G. Salzetti | Obstetrics & Gynecology | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-09-03 |
| 1407958978 | Danielle P. Twyman | Physician Assistant | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-09-03 |
| 1225130792 | Marcelline K. Welsh | Pediatrics | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-09-03 |
| 1033211685 | Julian J. Nicholas | Internal Medicine | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-09-03 |
| 1275635831 | Michael J. Rundell | Emergency Medicine | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-09-03 |
| 1477655082 | Margaret A. Drehobl | Family Medicine | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-09-03 |
| 1346342995 | Clifford G. Feaver | Podiatrist | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-09-03 |
| 1518069160 | Kimberly A. Longmire | Emergency Medicine | 15025 Innovation Dr, San Diego, CA 92128-3409 | 2006-09-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1376034348 | Eddie Reginald Burston II | In Home Supportive Care | 12727 Camino Emparrado, San Diego, CA 92128 | 2018-05-24 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700342748 | San Diego Uptown Pediatric Medical Group, Inc | Pediatrics | 3500 Fifth Ave Ste 101, San Diego, CA 92103-5020 | 2019-02-14 |
| 1467976340 | Cheryl Adele Burian | Pediatrics | 6572 Cascade St, San Diego, CA 92122-2425 | 2017-08-01 |
| 1043747819 | Karen Chan | Pediatrics | 3030 Childrens Way Fl 4, San Diego, CA 92123-4232 | 2017-05-11 |
| 1922462209 | Meaghan Wido | Pediatrics | Naval Medical Ctr 34800 Bob Wilson Drive, San Diego, CA 92134-5000 | 2016-04-12 |
| 1427434679 | Coast Pediatrics Carmel Valley | Pediatrics | 5965 Village Drive, Suite 201, San Diego, CA 92130 | 2015-08-10 |
| 1194104521 | Charles E Pohl IIi | Pediatrics | 3020 Childrens Way # Mc5065, San Diego, CA 92123-4223 | 2015-05-18 |
| 1477948479 | Thuan Diep | Pediatrics | 12036 Scripps Highlands Dr Ste 102, San Diego, CA 92131-5155 | 2015-04-06 |
| 1518352970 | Karen Ki Won Lee | Pediatrics | 3020 Childrens Way # Mc5035, San Diego, CA 92123-4223 | 2015-04-02 |
| 1730594235 | Jessie Su Bowers | Pediatrics | 12036 Scripps Highlands Dr # 102, San Diego, CA 92131-5155 | 2014-06-24 |
| 1154683043 | Daniel Micah Lichtmann | Pediatrics | 15004 Innovation Drive, San Diego, CA 92128 | 2012-06-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.