Jennifer Cobanov, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A108683 Issued in CA

Practice address

414 Tennessee St Ste K1
Redlands, CA 92373-8152

Phone

(909) 531-4427

Fax

(909) 288-4731

NPI assigned

Feb 9, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jennifer Cobanov, MD Professional Corporation

  • Pediatrics Physician
  • Redlands, CA
  • NPI 1619622636
  NPD Authorized official
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  NPD (past)
• Riverside Healthcare System, L.P.

  • Rehabilitation Hospital Unit
  • Riverside, CA
  • NPI 1053358010
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1396923579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 902",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923540902",
            "telephone_number": "909-647-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 TENNESSEE ST STE K1",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738152",
            "telephone_number": "909-531-4427",
            "fax_number": "909-288-4731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBANOV",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-09",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A108683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Clements
• Cliffordtaylorphdpsychologicalservicesinc
• Thomas James Clonch, D.D.S.
• Anne E Cloud, LMT
• Loretta Coakes, LCSW
• Melinda Anne Cockeram, IBCLC
• Veronica Joy Coen, PA-C
• Donald R Cofer Sr., MFTT
• Nathan Conrad Coffin, DC
• Seth Adam Cohen, MD

• Pediatrics Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.