Provider Demographics
NPI:1093816423
Name:COHEN, ROBYN GROSSMAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:GROSSMAN
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:GROSSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9834 GENESEE AVENUE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1221
Mailing Address - Country:US
Mailing Address - Phone:858-457-4090
Mailing Address - Fax:858-457-1543
Practice Address - Street 1:9834 GENESEE AVENUE
Practice Address - Street 2:SUITE 315
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1221
Practice Address - Country:US
Practice Address - Phone:858-457-4090
Practice Address - Fax:858-457-1543
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG26275207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG838030Medicaid
180041162OtherRAILROAD MEDICARE
WG83803CMedicare ID - Type Unspecified
180041162OtherRAILROAD MEDICARE