Healthcare Provider Details

I. General information

NPI: 1861724841
Provider Name (Legal Business Name): TROY FRANKLIN COOK R.N.F.A., C.N.O.R.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21616 CALIFA ST APT 312
WOODLAND HILLS CA
91367-4961
US

IV. Provider business mailing address

21616 CALIFA ST APT 312
WOODLAND HILLS CA
91367-4961
US

V. Phone/Fax

Practice location:
  • Phone: 818-312-6249
  • Fax:
Mailing address:
  • Phone: 818-312-6249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number590473
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN 3242862
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: