MEDICARE: LYNN P COATES 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	A35617	CA

General Provider Information

NPI Number	:	1851380315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN P COATES MD

Provider Business Mailing Address
First Line	:	824 E CARSON ST
Second Line	:	NUMBER 201
City	:	CARSON
State	:	CA
Zip	:	90745-2262
Country	:	US
Telephone Number	:	310-233-3228
Fax Number	:	310-233-3229

Provider Business Practice Location Address
First Line	:	824 E CARSON ST
Second Line	:	NUMBER 201
City	:	CARSON
State	:	CA
Zip	:	90745-2262
Country	:	US
Telephone Number	:	310-233-3228
Fax Number	:	310-233-3229

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	07/08/2007

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