Provider Demographics
NPI:1063992774
Name:COGEN, ZACHARY SCOTT (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:SCOTT
Last Name:COGEN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 SAN FERNANDO RD UNIT 2529
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2885
Mailing Address - Country:US
Mailing Address - Phone:516-359-7984
Mailing Address - Fax:
Practice Address - Street 1:ENGEMANN HEALTH CENTER 1031 W 34TH STREET SUITE 450
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0001
Practice Address - Country:US
Practice Address - Phone:213-740-0215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist