Healthcare Provider Details

I. General information

NPI: 1376599159
Provider Name (Legal Business Name): MELVIN W. COATS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9209 COLIMA RD STE 1000
WHITTIER CA
90605-1813
US

IV. Provider business mailing address

12900 PARK PLAZA DR STE 150
CERRITOS CA
90703-9329
US

V. Phone/Fax

Practice location:
  • Phone: 562-236-2290
  • Fax: 562-696-1104
Mailing address:
  • Phone: 562-622-2800
  • Fax: 562-741-4479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG66883
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: