MEDICARE: SHERILYNN E. COOKE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A71326	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427136506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERILYNN E. COOKE MD

Provider Business Mailing Address
First Line	:	1800 HARRISON ST FL 7
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94612-3466
Country	:	US
Telephone Number	:	510-625-6262
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 CROWN POINT CIR STE 110
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95945-9561
Country	:	US
Telephone Number	:	530-265-1450
Fax Number	:	530-271-0894

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	12/22/2021

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