Provider Demographics
NPI:1386446342
Name:COHENMEHR, KEVIN (OD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:COHENMEHR
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4926 TEXHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3740
Mailing Address - Country:US
Mailing Address - Phone:310-988-6336
Mailing Address - Fax:
Practice Address - Street 1:12222 WILSHIRE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1169
Practice Address - Country:US
Practice Address - Phone:310-828-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35923152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist