Provider Demographics
NPI:1962692343
Name:KOHN, BEN (MD)
Entity type:Individual
Prefix:DR
First Name:BEN
Middle Name:
Last Name:KOHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BEN
Other - Middle Name:
Other - Last Name:KOHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PROFESSION CORP
Mailing Address - Street 1:222 SURFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-2911
Mailing Address - Country:US
Mailing Address - Phone:310-454-0606
Mailing Address - Fax:310-459-7763
Practice Address - Street 1:222 SURFVIEW DR
Practice Address - Street 2:
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-2911
Practice Address - Country:US
Practice Address - Phone:310-454-0606
Practice Address - Fax:310-459-7763
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry