Provider Demographics
NPI:1710392840
Name:KOHAN, PEDRAM (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRAM
Middle Name:
Last Name:KOHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 S BEVERLY GLEN BLVD APT 307
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5237
Mailing Address - Country:US
Mailing Address - Phone:310-935-8367
Mailing Address - Fax:
Practice Address - Street 1:3831 HUGHES AVE STE 604
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6848
Practice Address - Country:US
Practice Address - Phone:626-575-7500
Practice Address - Fax:626-575-1956
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2024-09-10
Deactivation Date:2024-08-27
Deactivation Code:
Reactivation Date:2024-09-04
Provider Licenses
StateLicense IDTaxonomies
CAA156402207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine