MEDICARE: DR COOK REEDER & ASSOCS

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	152W00000X	Optometrist	OP6425T	CA

General Provider Information

NPI Number	:	1659381523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR COOK REEDER & ASSOCS

Provider Business Mailing Address
First Line	:	9320 CARMEL MOUNTAIN ROAD
Second Line	:	SUITE E
City	:	SAN DIEGO
State	:	CA
Zip	:	92129-2159
Country	:	US
Telephone Number	:	858-484-1500
Fax Number	:	858-484-9143

Provider Business Practice Location Address
First Line	:	9320 CARMEL MOUNTAIN ROAD
Second Line	:	SUITE E
City	:	SAN DIEGO
State	:	CA
Zip	:	92129-2159
Country	:	US
Telephone Number	:	858-484-1500
Fax Number	:	858-484-9143

Authorized Official
Title or Position	:	CFO OWNER
Name	:	JOEL LAIR COOK
Credential	:	OD
Telephone Number	:	858-484-1500

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	12/03/2008

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