Healthcare Provider Details

I. General information

NPI: 1659607315
Provider Name (Legal Business Name): IAN RICHARD COOK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2009
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38660 MEDICAL CENTER DR STE A150
PALMDALE CA
93551-4385
US

IV. Provider business mailing address

24307 MAGIC MOUNTAIN PKWY STE 69
VALENCIA CA
91355-3620
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-6946
  • Fax: 661-949-7206
Mailing address:
  • Phone: 661-425-5000
  • Fax: 661-200-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA107528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: