Healthcare Provider Details

I. General information

NPI: 1730226671
Provider Name (Legal Business Name): THOMAS FLOYD COYE R.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 PEACEKEEPER WAY
MCCLELLAN CA
95652-2600
US

IV. Provider business mailing address

25191 TASMAN RD
LAGUNA HILLS CA
92653-5034
US

V. Phone/Fax

Practice location:
  • Phone: 916-830-1515
  • Fax: 916-929-1861
Mailing address:
  • Phone: 949-510-4751
  • Fax: 916-929-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number361549
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: