Healthcare Provider Details

I. General information

NPI: 1326182957
Provider Name (Legal Business Name): SUSAN COLE SYKES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 E 12TH STREET
OAKLAND CA
94601
US

IV. Provider business mailing address

1601 FRUITVALE AVE
OAKLAND CA
94601-2322
US

V. Phone/Fax

Practice location:
  • Phone: 510-535-3317
  • Fax: 510-535-4248
Mailing address:
  • Phone: 510-535-4000
  • Fax: 510-535-4128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG61073
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: